Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria

Steven Kassakian, Leonard A. Mermel

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Community-associated infections caused by extended-spectrum beta-lactamase (ESBL) producing bacteria are a growing concern.Methods: Retrospective cohort study of clinical infections due to ESBL-producing bacteria requiring admission from 2006-2011 at a tertiary care academic medical center in Providence, RI.Results: A total of 321 infections due to ESBL-producing bacteria occurred during the study period. Fifty-eight cases (18%) were community-acquired, 170 (53%) were healthcare-associated, and 93 (29%) were hospital-acquired. The incidence of ESBL infections per 10,000 discharges increased during the study period for both healthcare-associated infections, 1.9 per year (95% CI 1-2.8), and for community-acquired infections, 0.85 per year (95% CI 0.3-1.4) but the rate remained unchanged for hospital-acquired infections. For ESBL-producing E. coli isolates, resistance to both ciprofloxacin and trimethoprim-sulfamethoxazole was 95% and 65%, respectively but 94% of isolates were susceptible to nitrofurantoin.Conclusions: Community-acquired and healthcare-associated infections due to ESBL-producing bacteria are increasing in our community, particularly urinary tract infections due to ESBL-producing E. coli. Most isolates are resistant to oral antibiotics commonly used to treat urinary tract infections. Thus, our findings have important implications for outpatient management of such infections.

Original languageEnglish (US)
Article number9
JournalAntimicrobial Resistance and Infection Control
Volume3
Issue number1
DOIs
StatePublished - Mar 25 2014
Externally publishedYes

Fingerprint

beta-Lactamases
Epidemiology
Bacteria
Infection
Cross Infection
Urinary Tract Infections
Escherichia coli
Community-Acquired Infections
Nitrofurantoin
Community Health Services
Sulfamethoxazole Drug Combination Trimethoprim
Tertiary Healthcare
Ciprofloxacin
Cohort Studies
Outpatients
Retrospective Studies
Anti-Bacterial Agents
Delivery of Health Care
Incidence

Keywords

  • Antimicrobial resistance
  • Ciprofloxacin
  • Community-acquired infections
  • Extended-spectrum beta-lactamase
  • Urinary tract infection

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)
  • Pharmacology (medical)
  • Public Health, Environmental and Occupational Health

Cite this

Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria. / Kassakian, Steven; Mermel, Leonard A.

In: Antimicrobial Resistance and Infection Control, Vol. 3, No. 1, 9, 25.03.2014.

Research output: Contribution to journalArticle

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