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dc.contributor.authorToner, Liam-
dc.contributor.authorPapa, Nathan P-
dc.contributor.authorAliyu, Sani H-
dc.contributor.authorDev, Harveer-
dc.contributor.authorLawrentschuk, Nathan-
dc.contributor.authorAl-Hayek, Samih-
dc.identifier.citationWorld Journal of Urology 2016; 34(7): 1031-1037-
dc.description.abstractExtended-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.-
dc.subjectDrug resistance, microbial-
dc.subjectUrinary tract infections-
dc.titleExtended-spectrum beta-lactamase-producing Enterobacteriaceae in hospital urinary tract infections: incidence and antibiotic susceptibility profile over 9 years.-
dc.typeJournal Article-
dc.identifier.journaltitleWorld Journal of Urology-
dc.identifier.affiliationOlivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Microbiology, Addenbrookes' Hospital, Cambridge University, Cambridge, UKen
dc.identifier.affiliationDepartment of Urology, Addenbrookes' Hospital, Cambridge University, Cambridge, UKen
dc.identifier.affiliationDepartment of Surgery, Urology Unit, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Urology, Austin Health, Heidelberg, Victoria, Australiaen
dc.type.austinJournal Article-, Liam
item.fulltextNo Fulltext-
item.openairetypeJournal Article-
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