OBJECTIVE: The incidence of infections from extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-E) is increasing in the United States. We describe the epidemiology of ESBL-E at 5 Emerging Infections Program (EIP) sites. METHODS: During October-December 2017, we piloted active laboratory- and population-based (New York, New Mexico, Tennessee) or sentinel (Colorado, Georgia) ESBL-E surveillance. An incident case was the first isolation from normally sterile body sites or urine of Escherichia coli or Klebsiella pneumoniae/oxytoca resistant to ≥1 extended-spectrum cephalosporin and nonresistant to all carbapenems tested at a clinical laboratory from a surveillance area resident in a 30-day period. Demographic and clinical data were obtained from medical records. The Centers for Disease Control and Prevention (CDC) performed reference antimicrobial susceptibility testing and whole-genome sequencing on a convenience sample of case isolates. RESULTS: We identified 884 incident cases. The estimated annual incidence in sites conducting population-based surveillance was 199.7 per 100,000 population. Overall, 800 isolates (96%) were from urine, and 790 (89%) were E. coli. Also, 393 cases (47%) were community-associated. Among 136 isolates (15%) tested at the CDC, 122 (90%) met the surveillance definition phenotype; 114 (93%) of 122 were shown to be ESBL producers by clavulanate testing. In total, 111 (97%) of confirmed ESBL producers harbored a blaCTX-M gene. Among ESBL-producing E. coli isolates, 52 (54%) were ST131; 44% of these cases were community associated. CONCLUSIONS: The burden of ESBL-E was high across surveillance sites, with nearly half of cases acquired in the community. EIP has implemented ongoing ESBL-E surveillance to inform prevention efforts, particularly in the community and to watch for the emergence of new ESBL-E strains.
OBJECTIVE: The incidence of infections from extended-spectrum β-lactamase (ESBL)-producing Enterobacterales (ESBL-E) is increasing in the United States. We describe the epidemiology of ESBL-E at 5 Emerging Infections Program (EIP) sites. METHODS: During October-December 2017, we piloted active laboratory- and population-based (New York, New Mexico, Tennessee) or sentinel (Colorado, Georgia) ESBL-E surveillance. An incident case was the first isolation from normally sterile body sites or urine of Escherichia coli or Klebsiella pneumoniae/oxytoca resistant to ≥1 extended-spectrum cephalosporin and nonresistant to all carbapenems tested at a clinical laboratory from a surveillance area resident in a 30-day period. Demographic and clinical data were obtained from medical records. The Centers for Disease Control and Prevention (CDC) performed reference antimicrobial susceptibility testing and whole-genome sequencing on a convenience sample of case isolates. RESULTS: We identified 884 incident cases. The estimated annual incidence in sites conducting population-based surveillance was 199.7 per 100,000 population. Overall, 800 isolates (96%) were from urine, and 790 (89%) were E. coli. Also, 393 cases (47%) were community-associated. Among 136 isolates (15%) tested at the CDC, 122 (90%) met the surveillance definition phenotype; 114 (93%) of 122 were shown to be ESBL producers by clavulanate testing. In total, 111 (97%) of confirmed ESBL producers harbored a blaCTX-M gene. Among ESBL-producing E. coli isolates, 52 (54%) were ST131; 44% of these cases were community associated. CONCLUSIONS: The burden of ESBL-E was high across surveillance sites, with nearly half of cases acquired in the community. EIP has implemented ongoing ESBL-E surveillance to inform prevention efforts, particularly in the community and to watch for the emergence of new ESBL-E strains.
Authors: Maris S Arcilla; Jarne M van Hattem; Manon R Haverkate; Martin C J Bootsma; Perry J J van Genderen; Abraham Goorhuis; Martin P Grobusch; Astrid M Oude Lashof; Nicky Molhoek; Constance Schultsz; Ellen E Stobberingh; Henri A Verbrugh; Menno D de Jong; Damian C Melles; John Penders Journal: Lancet Infect Dis Date: 2016-10-14 Impact factor: 25.071
Authors: Lapo Mughini-Gras; Alejandro Dorado-García; Engeline van Duijkeren; Gerrita van den Bunt; Cindy M Dierikx; Marc J M Bonten; Martin C J Bootsma; Heike Schmitt; Tine Hald; Eric G Evers; Aline de Koeijer; Wilfrid van Pelt; Eelco Franz; Dik J Mevius; Dick J J Heederik Journal: Lancet Planet Health Date: 2019-08
Authors: Y Doi; D L Paterson; P Egea; A Pascual; L López-Cerero; M D Navarro; J M Adams-Haduch; Z A Qureshi; H E Sidjabat; J Rodríguez-Baño Journal: Clin Microbiol Infect Date: 2010-01 Impact factor: 8.067
Authors: Michaela J Day; Katie L Hopkins; David W Wareham; Mark A Toleman; Nicola Elviss; Luke Randall; Christopher Teale; Paul Cleary; Camilla Wiuff; Michel Doumith; Matthew J Ellington; Neil Woodford; David M Livermore Journal: Lancet Infect Dis Date: 2019-10-22 Impact factor: 25.071
Authors: Patrick N A Harris; Paul A Tambyah; David C Lye; Yin Mo; Tau H Lee; Mesut Yilmaz; Thamer H Alenazi; Yaseen Arabi; Marco Falcone; Matteo Bassetti; Elda Righi; Benjamin A Rogers; Souha Kanj; Hasan Bhally; Jon Iredell; Marc Mendelson; Tom H Boyles; David Looke; Spiros Miyakis; Genevieve Walls; Mohammed Al Khamis; Ahmed Zikri; Amy Crowe; Paul Ingram; Nick Daneman; Paul Griffin; Eugene Athan; Penelope Lorenc; Peter Baker; Leah Roberts; Scott A Beatson; Anton Y Peleg; Tiffany Harris-Brown; David L Paterson Journal: JAMA Date: 2018-09-11 Impact factor: 56.272
Authors: Thierry Wirth; Daniel Falush; Ruiting Lan; Frances Colles; Patience Mensa; Lothar H Wieler; Helge Karch; Peter R Reeves; Martin C J Maiden; Howard Ochman; Mark Achtman Journal: Mol Microbiol Date: 2006-06 Impact factor: 3.501