Resistance Trend, Antibiotic Utilization and Mortality in Patients with E. coli Bacteraemia

Najmi, Amirreza; Karimi, Fateme; Kunhikatta, Vijayanarayan; Varma, Muralidhar; Nair, Sreekumaran

doi:10.3889/oamjms.2019.223

Cited by 4 publications

(2 citation statements)

References 35 publications

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“…Various authors showed different susceptibility patterns in their study. Nadiq IA & Najmi et al showed a susceptibility of 11.7% & 9.8% to ampicillin, respectively, in contrast to 100% resistance in our study 6,18 . Susceptibility to cefotaxime was comparable to a study conducted by Najmi and Nepal 18,14 .…”

Section: Resultscontrasting

confidence: 67%

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2023

IJPSR

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Background: Escherichia coli (E. coli) is one of the most common agents of bacterial infections, the emergence of multidrug resistance in E. coli has posed major threat to global health resulting in failure of treatment that leads to increased mortality and cost of healthcare facilities. Material and Methods: For this study, a total of 500 specimens like urine, blood, pus, stool, sputum and different body fluids received in the Clinical Microbiology Laboratory were processed and inoculated on culture plates (Blood agar, MacConkey agar, Cysteine Lactose Electrolyte Deficient Agar) and incubated at 37°C for 18-24 hours. After identification, E. coli was processed for Antibiotic susceptibility testing on Muller Hinton Agar using Kirby Baeur disk diffusion method. E. coli ATCC 25922 was used as reference strain. Results: Of 500 specimens received in clinical laboratory from different age groups, 180 were culture positive, of which 88 were E. coli isolates. 48(54.5%) E. coli isolates were obtained from female patients while 40(45.5%) were from male patients. Isolation of E. coli was highest in Urine (80.68%) followed by Pus and other samples. E. coli were 100% resistant to Ampicillin followed by ceftriaxone (85.2%) and ciprofloxacin (63.6%) whereas least resistance was observed in imipenem (21.6%), piperacillin-tazobactam (29.5%). Discussion: E. coli isolates exhibited high resistance to ampicillin &ceftriaxone. Consequently, an obligate need exists for antimicrobial resistance surveillance to provide clinically appropriate and cost effective therapy.

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Section: Resultscontrasting

confidence: 67%

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2023

IJPSR

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“…In an Indian study, the rates of AMC resistance in ESBL-positive and ESBL-negative E. coli were 100 and 77.6%, respectively. 18 Studies on urine isolates of E. coli in Turkey have shown AMC resistance rates in ESBL-positive E. coli of 68.6 to 100%. 17 19 In our study, AMC resistance rates were 66.7 and 29.4% in ESBL-positive and ESBL-negative E. coli strains.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Hasanli

Dağı

Arslan

2022

J Pediatr Infect Dis

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Objective Extraintestinal Escherichia coli isolates are the most common gram-negative pathogens in humans and cause urinary tract infections, sepsis, neonatal meningitis, and others. The aim of this study was to investigate the rates of antibiotic resistance and virulence factors (kpsM II, neuc K1, hlyF, fyuA, afa/draBC, sat, chuA, fimH, tsh, yfcv, ibeA, traT, iucD, usp, iutA, cnf1, hlyA, papC, sfa/focDE, and ompT) of E. coli strains isolated from blood and urine samples. Methods A total of 150 E. coli strains isolated from blood and urine samples sent to the Microbiology Laboratory, Faculty of Medicine Hospital, Selcuk University were included in the study. The identification and antibiotic susceptibility tests were performed with the VITEK 2 automated system. Multiplex polymerase chain reaction was used to detect the virulence genes. Results Although the highest antibiotic resistance rate found was against ampicillin (73.3%), the lowest rates were against ertapenem and meropenem (0.7%). Extended-spectrum β-lactamase positivity was 38% in E. coli blood isolates and 29% in urine. The highest rates of virulence genes were detected in fimH gene (92%). iutA gene was 91.3%, traT 76%, fyuA 50%, chuA 54.7%, iucD 46.7%, ompT 32.7%, yfcv 31.3%, hlyF 28.7%, sat 22%, papC and sfa/focDE 20%, kpsM II 19.3%, neuc K1 14.7%, tsh 13.3%, cnf1 6.7%, afa/draBC 6%, ibeA 5.3%, usp 4.7%, and hlyA 3.3%. kpsM II, tsh, hlyA, papC, sfa/focDE, and ompT genes were higher in blood isolates. Conclusion High antibiotic resistance rates and virulence genes were detected in E. coli strains in Konya, Turkey. This is the first study in Turkey where both a large number and a variety of virulence factors were investigated and compared. Multicenter studies are needed to better understand E. coli virulence.

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Antimicrobial resistance of bacteraemia in the emergency department of a German university hospital (2013–2018): potential carbapenem-sparing empiric treatment options in light of the new EUCAST recommendations

et al. 2019

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BackgroundThis study investigated predominant microorganisms causing community-onset bacteraemia at the medical emergency department (ED) of a tertiary-care university hospital in Germany from 2013 to 2018 and their antimicrobial susceptibility patterns.MethodsAntimicrobial resistance patterns in patients with positive blood cultures presenting to an internal medicine ED were retrospectively analysed.ResultsBlood cultures were obtained at 5191 of 66,879 ED encounters, with 1013 (19.5%) positive results, and true positive results at 740 encounters (diagnostic yield, 14.3%). The most frequently isolated relevant microorganisms were Enterobacterales (n = 439, 59.3%), Staphylococcus aureus (n = 92, 12.4%), Streptococcus pneumoniae (n = 34, 4.6%), Pseudomonas aeruginosa (n = 32, 4.3%), Streptococcus pyogenes (n = 16, 2.2%), Enterococcus faecalis (n = 18, 2.4%), and Enterococcus faecium (n = 12, 1.6%). Antimicrobial susceptibility testing revealed a high proportion of resistance against ampicillin-sulbactam in Enterobacterales (42.2%). The rate of methicillin-resistant Staphylococcus aureus was low (0.4%).Piperacillin-tazobactam therapy provided coverage for 83.2% of all relevant pathogens using conventional breakpoints. Application of the new European Committee on Antimicrobial Susceptibility Testing (EUCAST) recommendations increased the percentage of susceptible isolates to high-dose piperacillin-tazobactam to 92.8% (p < 0.001). Broad-spectrum carbapenems would only cover an additional 4.8%. The addition of vancomycin or linezolid extended coverage by just 1.7%.ConclusionsUsing an ureidopenicillin-beta-lactamase inhibitor combination at the high dose suggested by the new EUCAST recommendations provided nearly 93% coverage for relevant pathogens in patients with suspected bloodstream infection in our cohort. This might offer a safe option to reduce the empiric use of carbapenems. Our data support the absence of a general need for glycopeptides or oxazolidinones in empiric treatment.

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Resistance Trend, Antibiotic Utilization and Mortality in Patients with E. coli Bacteraemia

Cited by 4 publications

References 35 publications

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Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Antimicrobial resistance of bacteraemia in the emergency department of a German university hospital (2013–2018): potential carbapenem-sparing empiric treatment options in light of the new EUCAST recommendations

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