Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea
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Background: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI. Methods: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results. Results: Among 1,189 patients with CO BSI caused by E. coli, 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3–6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%). Conclusions: In Korea, 27% of CO E. coli BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted.
Abstract
Background: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI. Methods: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results. Results: Among 1,189 patients with CO BSI caused by E. coli, 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3–6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%). Conclusions: In Korea, 27% of CO E. coli BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted.
참고문헌 (38)
- Rodriguez-Baño J, "A change in the epidemiology of infections due to extended-spectrum beta-lactamase-producing organisms", Clin Infect Dis, 42, pp.935~937 (2006)
- Paterson DL, "Resistance in gram-negative bacteria: Enterobacteriaceae", Am J Infect Control, 34, pp.S20~S28 (2006)
- Pitout JD, "Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community", J Antimicrob Chemother, 56, pp.52~59 (2005)
- Johnson JR, "Escherichia coli sequence type ST131 as the major cause of serious multidrug-resistant E. coli infections in the United States", Clin Infect Dis, 51, pp.286~294 (2010)
- Doi Y, "The ecology of extended-spectrum beta-lactamases (ESBLs) in the developed world", J Travel Med, 24, pp.S44~S51 (2017)
- Rodríguez-Baño J, "Community-onset bacteremia due to extended-spectrum β-lactamase-producing Escherichia coli: risk factors and prognosis", Clin Infect Dis, 50, pp.40~48 (2010)
- Kang CI, "Risk factors and treatment outcomes of community-onset bacteraemia caused by extended-spectrum beta-lactamase-producing Escherichia coli", Int J Antimicrob Agents, 36, pp.284~287 (2010)
- Zahar JR, "Predominance of healthcare-associated cases among episodes of community-onset bacteraemia due to extended-spectrum β-lactamase-producing Enterobacteriaceae", Int J Antimicrob Agents, 49, pp.67~73 (2017)
- Quan J, "High prevalence of ESBL-producing Escherichia coli and Klebsiella pneumoniae in community-onset bloodstream infections in China", J Antimicrob Chemother, 72, pp.273~280 (2017)
- 김영준, "Change in the Annual Antibiotic Susceptibility of Escherichia coli in Community-Onset Urinary Tract Infection between 2008 and 2017 in a Tertiary Care Hospital in Korea", Journal of Korean Medical Science, 34(34), pp.1~6 (2019), 대한의학회
- 김도균, "Increasing Resistance to Extended-Spectrum Cephalosporins, Fluoroquinolone, and Carbapenem in Gram-Negative Bacilli and the Emergence of Carbapenem Non-Susceptibility in Klebsiella pneumoniae: Analysis of Korean Antimicrobial Resistance Monitoring System (KARMS) Data From 2013 to 2015", Annals of Laboratory Medicine, 37(3), pp.231~239 (2017), 대한진단검사의학회
- Lee H, "Establishment of the South Korean national antimicrobial resistance surveillance system, Kor-GLASS, in 2016", Euro Surveill, 2018(23), pp.1700734~ (2016)
- Friedman ND, "Health care–associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections", Ann Intern Med, 137, pp.791~797 (2002)
- CLSI, "Performance standards for antimicrobial susceptibility testing" (2016), Clinical and Laboratory Standards Institute
- Urban C, "Identification of CTX-M β-lactamases in Escherichia coli from hospitalized patients and residents of long-term care facilities", Diagn Microbiol Infect Dis, 66, pp.402~406 (2010)
- Yoon EJ, "Impact of host-pathogen-treatment tripartite components on early mortality of patients with Escherichia coli bloodstream infection: prospective observational study", EBioMedicine, 35, pp.76~86 (2018)
- Wirth T, "Sex and virulence in Escherichia coli: an evolutionary perspective", Mol Microbiol, 60, pp.1136~1151 (2006)
- Isendahl J, "Risk factors for community-onset bloodstream infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae: national population-based case-control study", Clin Microbiol Infect, 25, pp.1408~1414 (2019)
- Ben-Ami R, "A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients", Clin Infect Dis, 49, pp.682~690 (2009)
- Almog M, "Increasing antimicrobial resistance in long-term care facility patients with bacteremia: a 5 year’s surveillance", J Am Med Dir Assoc, 19, pp.1024~1026.e1 (2018)
- Yoo JS, "High prevalence of extended-spectrum beta-lactamases and plasmid-mediated AmpC beta-lactamases in Enterobacteriaceae isolated from long-term care facilities in Korea", Diagn Microbiol Infect Dis, 67, pp.261~265 (2010)
- Choi JP, "Influx of multidrug resistant, Gram-negative bacteria (MDRGNB) in a public hospital among elderly patients from long-term care facilities: a single-center pilot study", Arch Gerontol Geriatr, 54, pp.e19~e22 (2012)
- Choi MJ, "Spread of ceftriaxone non-susceptible pneumococci in South Korea: long-term care facilities as a potential reservoir", PLoS One, 14, pp.e0210520~ (2019)
- Kariya N, "Current prevention and control of health care-associated infections in long-term care facilities for the elderly in Japan", J Infect Chemother, 24, pp.347~352 (2018)
- Kang CI, "Clinical features and outcome of community-onset bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli", Eur J Clin Microbiol Infect Dis, 27, pp.85~88 (2008)
- Turnidge J, "Antimicrobial use and resistance–proving the obvious", Lancet, 365, pp.548~549 (2005)
- Kim H, "Risk factors and molecular features of sequence type (ST) 131 extended-spectrum beta-lactamase-producing Escherichia coli in community-onset bacteremia", Sci Rep, 7, pp.14640~ (2017)
- Kim YA, "Community-onset extended-spectrum-beta-lactamase-producing Escherichia coli sequence type 131 at two Korean community hospitals: the spread of multidrug-resistant E. coli to the community via healthcare facilities", Int J Infect Dis, 54, pp.39~42 (2017)
- Hu X, "Genetic contexts related to the diffusion of plasmid-mediated CTX-M-55 extended-spectrum beta-lactamase isolated from Enterobacteriaceae in China", Ann Clin Microbiol Antimicrob, 17, pp.12~ (2018)
- Young Ah Kim, "Whole-Genome Analysis of blaCTX-M-55-Carrying Escherichia coli Among Pigs, Farm Environment, and Farm Workers", Annals of Laboratory Medicine, 40(2), pp.180~183 (2020), 대한진단검사의학회[DOI]
- Kim Young Ah, "Prevalence and Molecular Epidemiology of Extended-Spectrum-β-Lactamase (ESBL)-Producing Escherichia coli From Multiple Sectors of the Swine Industry in Korea: A Korean Nationwide Monitoring Program for a One Health Approach to Combat Antimicrobial Resistance", Annals of Laboratory Medicine, 41(3), pp.285~292 (2021), 대한진단검사의학회[DOI]
- Bevan ER, "Global epidemiology of CTX-M beta-lactamases: temporal and geographical shifts in genotype", J Antimicrob Chemother, 72, pp.2145~2155 (2017)
- Kim SY, "Prevalence and characteristics of Escherichia coli sequence type 131 and its H30 and H30Rx subclones: a multicenter study from Korea", Diagn Microbiol Infect Dis, 84, pp.97~101 (2016)
- 이은영, "Prevalence of Escherichia coli Carrying pks Islands in Bacteremia Patients", Annals of Laboratory Medicine, 38(3), pp.271~273 (2018), 대한진단검사의학회[DOI]
- Burgess MJ, "Long-term care facilities are reservoirs for antimicrobial-resistant sequence type 131 Escherichia coli", Open Forum Infect Dis, 2, pp.ofv011~ (2015)
- Tchesnokova V, "The Uropathogenic Escherichia coli subclone sequence type 131-H 30 is responsible for most antibiotic prescription errors at an urgent care clinic", Clin Infect Dis, 68, pp.781~787 (2019)
- Johnson JR, "The pandemic H 30 subclone of Escherichia coli sequence type 131 is associated with persistent infections and adverse outcomes independent from its multidrug resistance and associations with compromised hosts", Clin Infect Dis, 62, pp.1529~1536 (2016)
- Peirano G, "Global incidence of carbapenemase-producing Escherichia coli ST131", Emerg Infect Dis, 20, pp.1928~1931 (2014)