Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19257
Title: Extended-spectrum beta-lactamase-producing Enterobacteriaceae in hospital urinary tract infections: incidence and antibiotic susceptibility profile over 9 years.
Austin Authors: Toner, Liam ;Papa, Nathan P;Aliyu, Sani H;Dev, Harveer;Lawrentschuk, Nathan;Al-Hayek, Samih
Affiliation: Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Microbiology, Addenbrookes' Hospital, Cambridge University, Cambridge, UK
Department of Urology, Addenbrookes' Hospital, Cambridge University, Cambridge, UK
Department of Surgery, Urology Unit, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Jul-2016
metadata.dc.date: 2015-10-28
Publication information: World Journal of Urology 2016; 34(7): 1031-1037
Abstract: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are an increasing concern regarding antibiotic resistance and their potential to cause serious infections which are difficult to treat. The purpose of this surveillance programme was to assess the incidence of ESBL in adults amongst urinary isolates, identify risk factors, and detail the antibiotic susceptibility profile in order to guide empirical treatment. From 2006 to 2014, we reviewed 21,414 positive urine cultures for E. coli and Klebsiella sp. from a University hospital in the UK and found 1420 ESBL-positive specimens. Susceptibility testing was performed by British Society of Antimicrobial Chemotherapy disc diffusion testing. ESBL screening was performed on samples resistant to cefpodoxime and confirmed by double disc diffusion (Oxoid Ltd, Basingstoke, UK). Patient gender, age, inpatient status, and catheterisation were assessed as risk factors. ESBL production amongst E. coli urine cultures increased 44 %, from 4.6 to 6.6 % of all E. coli isolates. ESBL-positive organisms were associated with increases in drug resistance, particularly amongst fluoroquinolones, trimethoprim, and cephalexin. Multidrug resistance was a feature with 75 % of ESBL+ Klebsiella sp.-resistant ≥6 antibiotic classes. ESBL producers remained largely susceptible to carbapenems. Male gender, urinary catheterisation, inpatient status, and increasing age were identified as risk factors for ESBL infection or colonisation. We demonstrate that the incidence of ESBL-producing E. coli in urine cultures is increasing and that such isolates are multidrug resistant. Carbapenems and nitrofurantoin for E. coli infections remain effective, which may guide empirical antibiotic therapy.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19257
DOI: 10.1007/s00345-015-1718-x
ORCID: 0000-0002-7288-3362
0000-0002-3188-1803
0000-0001-8553-5618
PubMed URL: 26511749
Type: Journal Article
Subjects: Drug resistance, microbial
Enterobacteriaceae
Fluoroquinolones
Nitrofurantoin
Urinary tract infections
Appears in Collections:Journal articles

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