Timi Martelius1,2, Jari Jalava2, Tommi Kärki2, Teemu Möttönen2, Jukka Ollgren2, Outi Lyytikäinen2. 1. a Department of Infectious Diseases , Inflammation Centre, Helsinki University Hospital and University of Helsinki, Inflammation Centre , Helsinki , Finland ; 2. b Institute of Health and Welfare , Department of Infectious Disease Surveillance and Control , Helsinki , Finland.
Abstract
BACKGROUND: Few systematically collected multi-centre surveillance data on nosocomial bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli or Klebsiella pneumoniae have been published. AIM: To evaluate trends, patient characteristics and mortality of such infections, nosocomial BSI data reported by the 4-17 hospitals participating in the prospective laboratory-based surveillance during 1999-2013 were analysed. METHODS: Data were collected by local infection control nurses, patient-days were obtained from the hospital's administrative database, and dates of deaths from the population registry. Resistance to third-generation cephalosporins was further examined in the national reference laboratory. FINDINGS: A total of 16 028 nosocomial BSIs were identified; 2217 (14%) were caused by E. coli and 661 (4%) by K. pneumoniae; 207 (7%) were non-susceptible to third-generation cephalosporins, with an increasing trend from 0% in 1999 to 17% in 2013. Patient characteristics did not differ significantly between BSIs caused by third-generation susceptible and resistant E. coli and K. pneumonia, but the case fatality tended to be higher. Most (88%) of the isolates reported as non-susceptible to third-generation cephalosporins had ESBL phenotype, CTX-M (79%) being the most common enzyme. CONCLUSION: A sharp increase in nosocomial BSIs caused by ESBL producing bacteria was observed. Identification of patients for screening pose a challenge, emphasising the role of infection control guidelines and antibiotic policy in prevention.
BACKGROUND: Few systematically collected multi-centre surveillance data on nosocomial bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli or Klebsiella pneumoniae have been published. AIM: To evaluate trends, patient characteristics and mortality of such infections, nosocomial BSI data reported by the 4-17 hospitals participating in the prospective laboratory-based surveillance during 1999-2013 were analysed. METHODS: Data were collected by local infection control nurses, patient-days were obtained from the hospital's administrative database, and dates of deaths from the population registry. Resistance to third-generation cephalosporins was further examined in the national reference laboratory. FINDINGS: A total of 16 028 nosocomial BSIs were identified; 2217 (14%) were caused by E. coli and 661 (4%) by K. pneumoniae; 207 (7%) were non-susceptible to third-generation cephalosporins, with an increasing trend from 0% in 1999 to 17% in 2013. Patient characteristics did not differ significantly between BSIs caused by third-generation susceptible and resistant E. coli and K. pneumonia, but the case fatality tended to be higher. Most (88%) of the isolates reported as non-susceptible to third-generation cephalosporins had ESBL phenotype, CTX-M (79%) being the most common enzyme. CONCLUSION: A sharp increase in nosocomial BSIs caused by ESBL producing bacteria was observed. Identification of patients for screening pose a challenge, emphasising the role of infection control guidelines and antibiotic policy in prevention.
Authors: Ana Oliveira; Henrique G Ribeiro; Ana C Silva; Maria D Silva; Jessica C Sousa; Célia F Rodrigues; Luís D R Melo; Ana F Henriques; Sanna Sillankorva Journal: Front Microbiol Date: 2017-12-08 Impact factor: 5.640
Authors: Wenzi Bi; Haiyang Liu; Rhys A Dunstan; Bin Li; Von Vergel L Torres; Jianming Cao; Lijiang Chen; Jonathan J Wilksch; Richard A Strugnell; Trevor Lithgow; Tieli Zhou Journal: Front Microbiol Date: 2017-06-30 Impact factor: 5.640
Authors: M C MacKinnon; J M Sargeant; D L Pearl; R J Reid-Smith; C A Carson; E J Parmley; S A McEwen Journal: Antimicrob Resist Infect Control Date: 2020-12-10 Impact factor: 4.887
Authors: Melissa C MacKinnon; Scott A McEwen; David L Pearl; Outi Lyytikäinen; Gunnar Jacobsson; Peter Collignon; Daniel B Gregson; Louis Valiquette; Kevin B Laupland Journal: BMC Infect Dis Date: 2021-06-25 Impact factor: 3.090