Epidemiological factors associated with ESBL- and non ESBL-producing<i>E. coli</i>causing urinary tract infection in general practice

Hertz, Frederik Boëtius; Schønning, Kristian; Rasmussen, Steen; Littauer, Pia; Knudsen, Jenny Dahl; Løbner-Olesen, Anders; Frimodt‐Møller, Niels

doi:10.3109/23744235.2015.1103895

Cited by 43 publications

(44 citation statements)

References 21 publications

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“…Strains with a zone diameter for cefpodoxime of ≤24 mm (Oxoid disks) were ESBL‐screening test‐positive. ESBL‐ or AmpC production was phenotypically confirmed by the MAST test, performed as a combined‐disk method, using disks containing cefpodoxime ±ESBL and/or AmpC inhibitors (MAST®, Merseyside, UK) (Hertz et al, ).…”

Section: Commentarymentioning

confidence: 99%

ESBL‐production in Escherichia coli and Klebsiella pneumoniae isolates from Nigeria

et al. 2019

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The worldwide increase in infections caused by extended‐spectrum beta‐lactamase‐ (ESBL) and AmpC‐producing Enterobacteriaceae (ESBL‐E) is a concern. Surveillance is extensive in Europe, North America, and Asia. Yet, there is no summarizing surveillance in Africa. This study aimed to perform a preliminary investigation on the prevalence of ESBL‐E in the northeastern part of Nigeria. However, of the 60 samples collected, we were able to culture 15 Escherichia coli and 7 Klebsiella spp. only. In the collection of clinical hospital samples, we found eight of 15 E. coli isolates to be ESBL (53%) and two out of seven Klebsiella spp. to be ESBL/AmpC (29%). Due to the limitations of this study, our findings cannot take a broad view on the prevalence of ESBL‐E, in Nigeria and other parts of Africa. Yet, to know which genes encode ESBL in Nigeria, and to know exact prevalence of every ESBL gene would be of importance.

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Section: Commentarymentioning

confidence: 99%

ESBL‐production in Escherichia coli and Klebsiella pneumoniae isolates from Nigeria

et al. 2019

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“…However, we adjusted for several documented proxies for infection severity, such as prior exposure to antibiotics, comorbidities, hospitalbased diagnosis of maternal infections and prior hospital admissions. [25][26][27] We feel confident that confounding by infection severity cannot fully explain our findings, although residual confounding cannot be completely rule out.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Use of antibiotics during pregnancy and risk of spontaneous abortion

Muanda

Sheehy

Bérard

2017

CMAJ

117

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BACKGROUND: Although antibiotics are widely used during pregnancy, evidence regarding their fetal safety remains limited. Our aim was to quantify the association between antibiotic exposure during pregnancy and risk of spontaneous abortion. METHODS:We conducted a nested case-control study within the Quebec Pregnancy Cohort (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009). We excluded planned abortions and pregnancies exposed to fetotoxic drugs. Spontaneous abortion was defined as having a diagnosis or procedure related to spontaneous abortion before the 20th week of pregnancy. The index date was defined as the calendar date of the spontaneous abortion. Ten controls per case were randomly selected and matched by gestational age and year of pregnancy. Use of antibiotics was defined by filled prescriptions between the first day of gestation and the index date and was compared with (a) non-exposure and (b) exposure to penicillins or cephalosporins. We studied type of antibiotics separately using the same comparator groups. RESULTS:After adjustment for potential confounders, use of azithromycin (adjusted odds ratio [OR] 1.65, 95% confidence interval [CI] 1.34-2.02; 110 exposed cases), clarithromycin (adjusted OR 2.35, 95% CI 1.90-2.91; 111 exposed cases), metronidazole (adjusted OR 1.70, 95% CI 1.27-2.26; 53 exposed cases), sulfonamides (adjusted OR 2.01, 95% CI 1.36-2.97; 30 exposed cases), tetracyclines (adjusted OR 2.59, 95% CI 1.97-3.41; 67 exposed cases) and quinolones (adjusted OR 2.72, 95% CI 2.27-3.27; 160 exposed cases) was associated with an increased risk of spontaneous abortion. Similar results were found when we used penicillins or cephalosporins as the comparator group. INTERPRETATION:After adjustment for potential confounders, use of macrolides (excluding erythromycin), quinolones, tetracyclines, sulfonamides and metronidazole during early pregnancy was associated with an increased risk of spontaneous abortion. Our findings may be of use to policy-makers to update guidelines for the treatment of infections during pregnancy.

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“…Several risk factors have been associated with ESBL organisms causing UTIs such as recurrent UTIs, prostatic disease, recent hospital admission, travel to high prevalence countries, recent antibiotic exposure including fluoroquinolone exposure, diabetes, previous instrumentation, old age and recreational fresh water swimming . One study from Denmark that confirmed antibiotic exposure within 30 days of UTI because of ESBL‐producing organism and multiple hospital admissions are linked with community UTIs especially ESBL‐producing Escherichia coli ( E coli ) . ESBL‐producing Enterobacteriaceae are usually linked with nosocomial infection but they are also widespread in the community settings.…”

Section: Introductionmentioning

confidence: 99%

Emerging clinical role of pivmecillinam in the treatment of urinary tract infections caused by Extended Spectrum βeta‐lactamase (ESBL) producing Enterobacteriaceae

Raja

2019

Int J Clin Pract

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Background: Extended Spectrum βeta-lactamase (ESBL)-producing Enterobacteriaceae causing urinary tract infections (UTIs) appear resistant to many common oral agents. There is a growing need to discover new antibiotics to combat with emerging antibiotic resistance problem. Until the discovery of new antimicrobials, we can bring back forgotten antibiotics to our clinical formulary. Pivmecillinam (prodrug of mecillinam), an oral antimicrobial agent is effective against ESBL producing organisms. We analysed the sensitivity rates of ESBL-producing Enterobacteriaceae from urine samples to mecillinam and to document if pivmecillinam is a suitable alternative option in the treatment of UTI. Materials/methods: This retrospective study was conducted from September 2015to September 2017. Data were collected from the pathology information system.Antimicrobial sensitivity testing on ESBL-producing Enterobacteriaceae isolates was carried out by disc diffusion method in accordance with The European Committee on Antimicrobial Susceptibility Testing. Results:A total of 986 ESBL-producing Enterobacteriaceae were tested for mecillinam during the study period. Of 986 organisms, Escherichia coli was the most common organism (889); followed by Klebsiella species (71) and others Enterobacteriaceae (26). Mecillinam sensitivity was found in 96% Escherichia coli (855/889 isolates), 83%Klebsiella species (59/71 isolates) and 88% other Enterobacteriaceae (23/26 isolates).Overall 95% (935/986 isolates) of ESBL-producing urinary isolates were sensitive to mecillinam.Conclusions: Pivmecillinam appears to be suitable option to treat ESBL-producing Enterobacteriaceae causing uncomplicated UTI. Our results showed low resistance rate to mecillinam. We recommend the use of pivmecillinam in uncomplicated UTIs because of ESBL-producing Enterobacteriaceae. More studies on in vitro activity of mecillinam against ESBL producing organism and its use and clinical outcome should be tried in future.

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Epidemiological factors associated with ESBL- and non ESBL-producingE. colicausing urinary tract infection in general practice

Cited by 43 publications

References 21 publications

ESBL‐production in Escherichia coli and Klebsiella pneumoniae isolates from Nigeria

ESBL‐production in Escherichia coli and Klebsiella pneumoniae isolates from Nigeria

Use of antibiotics during pregnancy and risk of spontaneous abortion

Emerging clinical role of pivmecillinam in the treatment of urinary tract infections caused by Extended Spectrum βeta‐lactamase (ESBL) producing Enterobacteriaceae

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