Wan-Lin Tsai1, Chih-Hsin Hung2, Hui-An Chen3, Jiun-Ling Wang4, I-Fei Huang3, Yee-Hsuan Chiou5, Yao-Shen Chen6, Susan Shin-Jung Lee6, Wan-Yu Hung2, Ming-Fang Cheng7. 1. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. 2. Department of Chemical Engineering, Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan, ROC. 3. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC. 4. Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC. 5. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Fooyin University, Kaohsiung, Taiwan, ROC. 6. School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC. 7. Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC; School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC; Fooyin University, Kaohsiung, Taiwan, ROC. Electronic address: mfcheng@vghks.gov.tw.
Abstract
BACKGROUND/ PURPOSE: The prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. This study investigated the clinical features and bacteriology of pediatric patients with ESBL-producing E. coli bacteremia and compared their characteristics with those of adult patients. METHODS: Clinical and laboratory data from all of the 41 patients aged ≤18 years diagnosed with E. coli bacteremia were collected over 5 years. Patients aged >18 years diagnosed with E. coli bacteremia, matched 1:1 for calendar time, were enrolled as the adult group. All E. coli isolates were tested for their blaCTX-M group and sequence type 131 (ST131). A novel seven-single nucleotide polymorphism-based clonotyping test was applied to detect the septatypes of each isolate. RESULTS: In the adult group, patients with ESBL-producing E. coli bacteremia had more previous hospitalizations and antimicrobial agent use than did those with non-ESBL-producing E. coli bacteremia, but these differences were not found in pediatric group. In the pediatric group, the proportion of isolates producing CTX-M group 9 was higher than that in the adult group (85.7% vs. 42.9%; p < 0.05). Among both groups, there were more E. coli ST131 in ESBL isolates in than there were non-ESBL isolates. The distribution of septatypes was more homogenous in ESBL-producing E. coli among the pediatric patients than among the adult patients. CONCLUSION: ST131 was the major clone causing E. coli bacteremia in both pediatric and adult populations. The pediatric population demonstrated a higher number of isolates producing CTX-M group 9 with more homogenous septatypes compared with the adult population.
BACKGROUND/ PURPOSE: The prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is increasing worldwide. This study investigated the clinical features and bacteriology of pediatric patients with ESBL-producing E. coli bacteremia and compared their characteristics with those of adult patients. METHODS: Clinical and laboratory data from all of the 41 patients aged ≤18 years diagnosed with E. coli bacteremia were collected over 5 years. Patients aged >18 years diagnosed with E. coli bacteremia, matched 1:1 for calendar time, were enrolled as the adult group. All E. coli isolates were tested for their blaCTX-M group and sequence type 131 (ST131). A novel seven-single nucleotide polymorphism-based clonotyping test was applied to detect the septatypes of each isolate. RESULTS: In the adult group, patients with ESBL-producing E. coli bacteremia had more previous hospitalizations and antimicrobial agent use than did those with non-ESBL-producing E. coli bacteremia, but these differences were not found in pediatric group. In the pediatric group, the proportion of isolates producing CTX-M group 9 was higher than that in the adult group (85.7% vs. 42.9%; p < 0.05). Among both groups, there were more E. coli ST131 in ESBL isolates in than there were non-ESBL isolates. The distribution of septatypes was more homogenous in ESBL-producing E. coli among the pediatric patients than among the adult patients. CONCLUSION:ST131 was the major clone causing E. coli bacteremia in both pediatric and adult populations. The pediatric population demonstrated a higher number of isolates producing CTX-M group 9 with more homogenous septatypes compared with the adult population.
Authors: Yanhong Jessika Hu; Anju Ogyu; Benjamin J Cowling; Keiji Fukuda; Herbert H Pang Journal: Bull World Health Organ Date: 2019-05-14 Impact factor: 9.408