Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Patients with Liver Cirrhosis

Abstract

Background: This study aimed to investigate the frequency of sequence type (ST) 131 strains and outcome of cirrhotic patients with bloodstream infections (BSIs) caused by extended-spectrum beta-lactamase-producing Escherichiacoli (ESBLEC) and non-extended-spectrum beta-lactamase-producing Escherichiacoli (NESBLEC). Methods: The incidence of ST 131 strains, hospital stay, and 30-day re-admission/mortality were compared between 51 ESBLEC and 51 NESBLEC bacteremic patients with cirrhosis. Results: ST 131 strains were found in 35.3% of the ESBLEC group and 0% of the NESBLEC group (p < 0.001). Mean hospital stay was 26.5 days in the ESBLEC group and 17.1 days in the NESBLEC group (p = 0.006). Thirty-day re-admission rates were 11.8% in the ESBLEC group and 5.9% in the NESBLEC group (p = 0.5). ST 131 strains were associated with 30-day re-admission (odds ratio: 4.5, 95% confidence interval: 1.1–18.9). Thirty-day mortality rate was 31.4% in the ESBLEC group and 23.5% in the NESBLEC group (p = 0.4). Conclusion: In patients with cirrhosis, the ESBLEC BSIs group had a higher frequency of ST 131 strains and longer hospital stay than the NESBLEC BSIs group with similar 30-day re-admission/mortality. ST 131 strains were associated with 30-day re-admission.

Escherichia/Shigella, SCFAs, and Metabolic Pathways—The Triad That Orchestrates Intestinal Dysbiosis in Patients with Decompensated Alcoholic Cirrhosis from Western Mexico

“…Patients with decompensated cirrhosis have a high risk of severe bacterial infection; therefore, prophylaxis with third-generation cephalosporins is recommended [73]. Nevertheless, the prevalence of β-lactam resistance infections has increased in parallel with the frequency and lethality [74][75][76]. Moreover, empiric antibiotic prophylaxis, added to the multiple hospital admissions, is a factor that results in the gain of antibiotic resistance genes in the intestinal microbiota [77,78].…”

Molecular Epidemiology of Escherichia coli Clinical Isolates from Central Panama

“…All isolates with phenotype ESBL were screened for bla SHV, bla TEM and bla CTX-M gene families by a PCR assay using specific primers as previously described [ 28 ]. bla CTX-M groups 1, 2, 8, 9, 25 and group 1 variant (CTX-M-15) were identified by a PCR assay using specific primers as previously described [ 29 , 30 ].…”

Distribution and Genomic Characterization of Third-Generation Cephalosporin-Resistant Escherichia coli Isolated from a Single Family and Home Environment: A 2-Year Longitudinal Study

“…The fecal carriage rate of ESBL-producing E. coli varies globally; the highest carriage rate was observed in Southeast Asia (27%), whereas the lowest rate was reported in Europe (6%) over the last 20 years [ 6 ]. Some studies conducted in Taiwan have discovered trends paralleling the global increase in the prevalence of ESBL-carrying E. coli [ 7 , 8 , 9 , 10 , 11 ]. As in other East Asian regions, the dominant ESBL-producing E. coli strain in southern Taiwan is O25b-ST131, which produces CTX-M-14 [ 7 , 8 , 9 , 10 ].…”

“…Some studies conducted in Taiwan have discovered trends paralleling the global increase in the prevalence of ESBL-carrying E. coli [ 7 , 8 , 9 , 10 , 11 ]. As in other East Asian regions, the dominant ESBL-producing E. coli strain in southern Taiwan is O25b-ST131, which produces CTX-M-14 [ 7 , 8 , 9 , 10 ]. Plasmid-mediated transmission has facilitated the rise in the prevalence of ESBL-carrying E. coli among healthy humans [ 12 ].…”