Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea

Baek Yae Jee; Kim Young Ah; Kim Dokyun; Shin Jong Hee; Uh Young; Shin Kyeong Seob; Shin Jeong Hwan; Jeong Seok Hoon; Lee Geun Woo; Lee Eun Ji; Kim Dong-Sook; Park Yoon Soo

doi:10.3343/alm.2021.41.5.455

Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea

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Type: Academic journal

Author: Baek Yae Jee (Department of Internal Medicine Yonsei University College of Medicine Seoul Korea) Kim Young Ah (Department of Laboratory Medicine National Health Insurance Service Ilsan Hospital Goyang Korea) Kim Dokyun (Department of Laboratory Medicine and Research Institute of Bacterial Resistance Yonsei University)

Journal: 대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제41권 제5호 KCI Accredited Journals

Published: 2021.9

Pages: 455 - 462 (8page)

DOI: 10.3343/alm.2021.41.5.455

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Risk Factors for Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Community-Onset Bloodstream Infection: Impact on Long-Term Care Hospitals in Korea

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Background: The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in the community has increased worldwide due to multifactorial reasons. ESBL-EC bloodstream infection (BSI) complicates the decision for proper antimicrobial administration. In this multicenter study, we investigated the prevalence, risk factors, and molecular background of community-onset (CO) ESBL-EC BSI. Methods: We included data for all episodes of ESBL-EC BSI of community origin from May 2016 to April 2017 obtained from the Korean national antimicrobial resistance surveillance system, which comprises six sentinel hospitals. Data, including previous history of admission and use of antimicrobials and medical devices before BSI, were collected, along with microbiological analysis results. Results: Among 1,189 patients with CO BSI caused by E. coli, 316 (27%) were identified as ESBL producers. History of admission, especially to a long-term care hospital (LTCH), and previous use of β-lactams/β-lactamase inhibitors, carbapenem, lincosamide, aminoglycoside, and extended-spectrum cephalosporin were independent risk factors for CO ESBL-EC BSI; admission to an LTCH showed the highest odds ratio (3.8, 95% confidence interval 2.3?6.1). The most common genotype was CTX-M-15 (N=131, 41%), followed by CTX-M-14 (N=86, 27%). ST131 was the most common sequence type among ESBL-EC groups (57%). Conclusions: In Korea, 27% of CO E. coli BSI were caused by ESBL producers. From perspectives of empirical treatment and infection control, history of admission to an LTCH and antimicrobial use should be noted.

#Community-onset infection #Extended-spectrum β-lactamase-producing Escherichia coli #Bloodstream infection #Prevalence #Risk factors #Molecular background

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김영준 / 2019 / Change in the Annual Antibiotic Susceptibility of Escherichia coli in Community-Onset Urinary Tract Infection between 2008 and 2017 in a Tertiary Care Hospital in Korea / Journal of Korean Medical Science 34(34):1~6

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Kim Young Ah / 2021 / Prevalence and Molecular Epidemiology of Extended-Spectrum-β-Lactamase (ESBL)-Producing Escherichia coli From Multiple Sectors of the Swine Industry in Korea: A Korean Nationwide Monitoring Program for a One Health Approach to Combat Antimicrobial Resistance / Annals of Laboratory Medicine 41(3):285~292

이은영 / 2018 / Prevalence of Escherichia coli Carrying pks Islands in Bacteremia Patients / Annals of Laboratory Medicine 38(3):271~273

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