This article is more than 5 years old. Information may no longer be current.
ESBL-producing E. coli increases in community hospitals in southeastern US
Click Here to Manage Email Alerts
SAN DIEGO — Data presented at IDWeek 2015 demonstrated an increase in extended-spectrum beta-lactamase–producing Escherichia coli infections in community hospitals throughout the southeastern United States.
There was no increase, however, in the incidence of extended-spectrum beta-lactamase (ESBL)–producing Klebsiella pneumoniae.
“Clinicians in community hospitals must be aware of this change in epidemiology,” Joshua T. Thaden, MD, PhD, from the division of infectious diseases at Duke University Medical Center, and colleagues wrote.
Joshua T. Thaden
During a presentation, Thaden said several studies have shown an increasing number of community-associated infections vs. hospital-onset infections at tertiary medical institutions, but data on the molecular epidemiology of smaller hospitals in the community are limited.
“This is an important issue as half of the medical care in the United States takes place in community hospitals,” Thaden said.
Thaden and colleagues identified 925 patients with ESBL-producing E. coli and 463 patients with K. pneumoniae infections at 26 community hospitals through the Duke Infection Control Outreach Network (DICON) from January 2009 to December 2014. During the study, the incidence of ESBL-producing E. coli infections increased from 5.28 to 10.5 patients per 100,000 patient-days (P = .006), and the number of community hospitals with ESBL-E. coli infections increased from 69% to 81%. In contrast, the incidence of ESBL-producing K. pneumoniae remained unchanged, with 88% of hospitals reporting at least one case of ESBL-producing K. pneumoniae infection.
ESBL-producing E. coli infections were more common than K. pneumoniae in women (54% vs 44%, P < .001) and white or Hispanic patients (P < .00001). Furthermore, ESBL-producing E. coli were more likely to be associated with the urinary tract (61% vs 52%, P < .00001) and more often community-acquired (23% vs 10%, P < .00001) and admitted from home (57% vs 48%, P = .003). Patients on dialysis (5% vs 8%, P = .01) and those admitted to the ICU were less likely to have ESBL-producing E. coli (14% vs 19%, P = .02). These data also were published in Infection Control and Hospital Epidemiology.
“Further molecular epidemiological examination of ESBL-producing bacterial infections is needed to understand the particular bacterial clones and particular biochemical mechanisms that are driving antibiotic resistance,” Thaden concluded. – by Stephanie Viguers
References:
Thaden JT, et al. Abstract 1383. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.
Thaden JT, et al. Infect Control Hosp Epidemiol. 2015;doi:10.1017/ice.2015.239.
Disclosure: Thaden reports no relevant financial disclosures.