A ten-year review of ESBL and non-ESBL Escherichia coli bloodstream infections among children at a tertiary referral hospital in South Africa
Autoři:
Oliver Ombeva Malande aff001; James Nuttall aff001; Vashini Pillay aff001; Colleen Bamford aff003; Brian Eley aff001
Působiště autorů:
Paediatric Infectious Diseases Unit, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
aff001; Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
aff002; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
aff003; Division of Microbiology, University of Cape Town, Cape Town, South Africa
aff004
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0222675
Souhrn
Introduction
There are few studies describing Escherichia coli (E. coli) bloodstream infection (BSI) among children in Africa, yet E.coli is increasing in importance as a cause of antibiotic resistant infection in paediatric settings.
Methods
In this retrospective, descriptive study aspects of E. coli BSI epidemiology are described over a 10-year period including incidence risk, risk factors for extended-spectrum β-lactamase (ESBL)-producing E. coli BSI, antibiotic susceptibility of the bacterial isolates and outcome including risk factors for severe disease.
Results
There were 583 new E. coli BSI episodes among 217,483 admissions, an overall incidence risk of 2.7 events/1,000 hospital admissions. Of 455 of these E. coli BSI episodes that were analysed, 136 (29.9%) were caused by ESBL-producing isolates. Risk factors for ESBL-producing E. coli BSI included hospitalization in the 28-day period preceding E. coli BSI episodes, having an underlying chronic illness other than HIV infection at the time of the E. coli BSI and having a temperature of 38° Celsius or higher at the time of the E. coli BSI. None of the E. coli isolates were resistant to carbapenems or colistin. The mortality rate was 5.9% and admission to the intensive care unit was required in 12.3% of BSI episodes. Predictors of severe disease included age less than 1 month, hospitalization in the 28-day period preceding E. coli BSI and BSI without a definable focus.
Conclusions
These findings extend our understanding of E. coli BSI in a sub-Saharan African setting, provide useful information that can guide empiric treatment choices for community- and hospital-acquired BSI and help inform prevention strategies.
Klíčová slova:
Antibiotics – Bloodstream infections – Escherichia coli – Escherichia coli infections – HIV infections – Hospitals – Medical risk factors – Nosocomial infections
Zdroje
1. Burdet C, Clermont O, Bonacorsi S, Laouénan C, Bingen E, Aujard Y, et al. Escherichia coli bacteremia in children: age and portal of entry are the main predictors of severity. Pediatr Infect Dis J. 2014; 33(8):872–9. doi: 10.1097/INF.0000000000000309 25222308
2. Lochan H, Bamford C, Eley B. Blood cultures in sick children. S Afr Med J. 2013; 103(12):918–920. doi: 10.7196/samj.6979 24300629
3. Dramowski A, Cotton M, Rabie H, Whitelaw A. Trends in paediatric bloodstream infections at a South African referral hospital. BMC Pediatrics 2015; 15:33, doi: 10.1186/s12887-015-0354-3 25884449
4. Lochan H, Pillay V, Bamford C, Nuttall J, Eley B. Bloodstream infections at a tertiary level paediatric hospital in South Africa. BMC Infect Dis. 2017; 17(1):750. doi: 10.1186/s12879-017-2862-2 29207958
5. Larru B, Gong W, Vendetti N, Sullivan KV, Localio R, Zaoutis TE, et al. Bloodstream Infections in Hospitalized Children: Epidemiology and Antimicrobial Susceptibilities. Pediatr Infect Dis J. 2016; 35(5):507–10. doi: 10.1097/INF.0000000000001057 26766146
6. McKay R, Bamford C. Community—versus healthcare-acquired bloodstream infections at Groote Schuur Hospital, Cape Town, South Africa. S Afr Med J. 2015; 6;105(5):363–9. doi: 10.7196/samj.8183 26242664
7. Murray S, Peaper R. The contribution of extended-spectrum β-lactamases to multidrug-resistant infections in children. Curr Opin Pediatr. 2015; 27(1):124–31. doi: 10.1097/MOP.0000000000000182 25565574
8. McDanel J, Schweizer M, Crabb V, Nelson R, Samore M, Khader K, et al. Incidence of Extended-Spectrum β-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella Infections in the United States: A Systematic Literature Review. Infect Control Hosp Epidemiol. 2017; 38(10):1209–1215. doi: 10.1017/ice.2017.156 28758612
9. Pitout JD, Thomson KS, Hanson ND, Ehrhardt AF, Moland ES, Sanders CC. Beta-Lactamases responsible for resistance to expanded-spectrum cephalosporins in Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis isolates recovered in South Africa. Antimicrob Agents Chemother. 1998; 42(6):1350–4. 9624474.
10. Peirano G, van Greune CH, Pitout JD, Characteristics of infections caused by extended-spectrum β-lactamase-producing Escherichia coli from community hospitals in South Africa. Diagn Microbiol Infect Dis. 2011; 69(4):449–53. doi: 10.1016/j.diagmicrobio.2010.11.011 21396544.
11. Buys H, Muloiwa R, Bamford C, Eley B. Klebsiella pneumoniae bloodstream infections at a South African children’s hospital 2006–2011, a cross-sectional study. BMC Infectious Diseases 2016; 16:570. doi: 10.1186/s12879-016-1919-y 27751185
12. Tacconelli E, au>Magrini N. Global Priority List of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics, WHO Essential medicines and health products guidelines (2017), Accessed on 8th August, 2017: http://www.who.int/medicines/publications/global-priority-list-antibiotic-resistant-bacteria/en/
13. Clinical and Laboratory Standards Institute. (2005). Performance standard for antimicrobial susceptibility testing. Document M100-S15. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA, 2005.
14. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Sixteenth Informational Supplement (2006). CLSI document M100-S16 [ISBN 1-56238-588-7]. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087–1898 USA, 2006.
15. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement (2007). CLSI document M100-S17 [ISBN 1-56238-625-5]. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 140 0, Wayne, Pennsylvania 19087–1898 USA, 2007.
16. Clinical and Laboratory Standards Institute. 2008. Development of in vitro susceptibility testing criteria and quality control parameters, 3rd ed (2008). CLSI M23-A3. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 140 0, Wayne, Pennsylvania 19087–1898 USA, 2008.
17. Clinical and Laboratory Standards Institute, Performance standards for antimicrobial susceptibility testing. Nineteenth informational supplement (2009) M100-S19, Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 140 0, Wayne, Pennsylvania 19087–1898 USA, 2009.
18. Clinical and Laboratory Standards Institute. (2010). Performance standards for antimicrobial susceptibility testing: 20th informational supplement. CLSI document M100-S20. Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 140 0, Wayne, Pennsylvania 19087–1898 USA, 2010.
19. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-First Informational Supplement (2011). CLSI document M100-S21. ISBN 1-56238-742-1, ISSN 0273-3099, Clinical and Laboratory Standards Institute, 940 West Valley Road, Suite 140 0, Wayne, Pennsylvania 19087–1898 USA, 2011.
20. Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Disk Susceptibility Tests; Approved Standard—Eleventh Edition (2012). CLSI document M02-A11 (ISBN 1-56238-781-2 [Print]; ISBN 1-56238-782-0 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2012.
21. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement (2013). CLSI document M100-S23 (ISBN 1-56238-865-7 [Print]; ISBN 1-56238-866-5 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087, USA, 2013.
22. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement (2014). CLSI document M100-S24 (ISBN 1-56238-897-5 [Print]; ISBN 1-56238-898-3 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2014.
23. Cardoso T, Almeida M, Friedman ND, Aragão I, Costa-Pereira A, Sarmento AE, et al. Classification of healthcare-associated infection: a systematic review 10 years after the first proposal. BMC Med. 2014; 12:40. doi: 10.1186/1741-7015-12-40 24597462.
24. Schneider E, Whitmore S, Glynn KM, Dominguez K, Mitsch A, McKenna MT, et al. Centers for Disease Control and Prevention (CDC). Revised surveillance case definitions for HIV infection among adults, adolescents, and children aged <18 months and for HIV infection and AIDS among children aged 18 months to <13 years—United States. MMWR Recomm Rep. 2008; 57(RR-10):1–12. 19052530.
25. de Onis M, Habicht JP. Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee (1996). Am J Clin Nutr. 64:650–658. doi: 10.1093/ajcn/64.4.650 8839517.
26. Goldstein B, Giroir B, Randolph A; International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in paediatrics. Pediatr Crit Care Med. 2005; 6(1):2–8. doi: 10.1097/01.PCC.0000149131.72248.E6 15636651.
27. Angus DC and van der Poll T. Severe Sepsis and Septic Shock. N Engl J Med. 2013; 369:840–51. doi: 10.1056/NEJMra1208623 23984731.
28. Hilty M, Betsch BY, Bögli-Stuber K, Heiniger N, Stadler M, Küffer M, et al. Transmission dynamics of extended-spectrum β-lactamase-producing Enterobacteriaceae in the tertiary care hospital and the household setting. Clin Infect Dis. 2006; 55(7):967–75. doi: 10.1093/cid/cis581 22718774
29. Gurieva T, Dautzenberg MJD, Gniadkowski M, Derde LPG, Bonten MJM, Bootsma MCJ. The Transmissibility of Antibiotic-Resistant Enterobacteriaceae in Intensive Care Units. Clin Infect Dis. 2018; 66(4):489–493. doi: 10.1093/cid/cix825 29020273.
30. Harris PNA, Tambyah PA, Lye DC, Mo Y, Lee TH, Yilmaz M, et al. Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial. J Am Med Assoc. 2018; 320(10):984–994. doi: 10.1001/jama.2018.12163 30208454.
31. Centres for Diseases Control and Prevention, Atlanta. Identifying healthcare-associated infections (HAI) for NHSN surveillance, January (2018). URL: https://www.cdc.gov/nhsn/pdfs/pscmanual/2psc_identifyinghais_nhsncurrent.pdf (accessed 26 February 2018).
32. Harris PN. Clinical management of infections caused by Enterobacteriaceae that express extended-spectrum β-lactamase and AmpC enzymes. Semin Respir Crit Care Med. 2015; 36(1):56–73. doi: 10.1055/s-0034-1398387 25643271.
33. Evans SR & Harris AD. Methods and issues in studies of CRE. Virulence 2017; 8(4):453–59. doi: 10.1080/21505594.2016.1213473 27470534.
34. Kaye KS, Harris AD, Samore M, Carmeli Y. The case-case-control study design: Addressing the limitations of risk factor studies for antimicrobial resistance. Infect Control Hosp Epidemiol. 2005; 26(4):346–51. doi: 10.1086/502550 15865269.
Článek vyšel v časopise
PLOS One
2019 Číslo 9
- Jak a kdy u celiakie začíná reakce na lepek? Možnou odpověď poodkryla čerstvá kanadská studie
- Pomůže v budoucnu s triáží na pohotovostech umělá inteligence?
- Spermie, vajíčka a mozky – „jednohubky“ z výzkumu 2024/38
- Skotská studie upřesnila zdravotní benefity aktivního cestování za prací a studiem
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?