Epidemiology of Escherichia coli as a Critical Pathogen of Bloodstream Infection Patients in Tertiary Referral Hospital
Downloads
Bloodstream infections (BSI), caused primarily by multidrug-resistant Escherichia coli, are a significant cause of morbidity and mortality worldwide. This study aims to evaluate the epidemiology of E. coli as a critical pathogen in patients with bloodstream infections in a tertiary referral hospital. This is a retrospective study using a descriptive observational research design. This study used a medical record instrument for bloodstream patients in Dr. Soetomo Hospital's inpatient ward with Gram-negative bacteria results of blood cultures in the Clinical Microbiology Laboratory from April 2021 to September 2021. The observed variables include; antimicrobial sensitivity, patient clinical characteristics, demographic data, clinical diagnosis, and clinical outcome. In 6 months, 276 Gram-negative bloodstream infection patients were treated at Dr. Soetomo Hospital. The proportion of E. coli was 17 %. The main characteristics of patients were over 60 years old (28%), and 54% were female. 63% of E. coli were ESBL, and 9% were carbapenem-resistant microorganisms. High antimicrobial resistance was found in quinolones (100%), ampicillin (93%), piperacillin (74%), tetracycline (72%), ceftriaxone (66%), cefotaxime (65%), ceftazidime (60%), cefazolin (65%), and trimethoprim-sulfamethoxazole (65%). The most common potential determinant profile discovered was linked to immunocompromised status due to malignancy. The high number of antimicrobial-resistant bacteria showed the importance of strict infection control and updated epidemiology data as a guide for empirical antimicrobial therapy.
Timsit JF, Ruppé E, Barbier F, Tabah A, Bassetti M. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med [Internet]. 2020;46(2):266–84. Available from: https://doi.org/10.1007/s00134-020-05950-6
Adrie C, Garrouste-Orgeas M, Ibn Essaied W, Schwebel C, Darmon M, Mourvillier B, et al. Attributable mortality of ICU-acquired bloodstream infections: Impact of the source, causative micro-organism, resistance profile and antimicrobial therapy. J Infect [Internet]. 2017;74(2):131–41. Available from: http://dx.doi.org/10.1016/j.jinf.2016.11.001
Diekema DJ, Hsueh PR, Mendes RE, Pfaller MA, Rolston K V., Sader HS, et al. The microbiology of bloodstream infection: 20-year trends from the SENTRY antimicrobial surveillance program. Antimicrob Agents Chemother. 2019;63(7).
De Angelis G, Fiori B, Menchinelli G, D'Inzeo T, Liotti FM, Morandotti GA, et al. Incidence and antimicrobial resistance trends in bloodstream infections caused by ESKAPE and Escherichia coli at a large teaching hospital in Rome, a 9-year analysis (2007–2015). Eur J Clin Microbiol Infect Dis. 2018;37(9):1627–36.
WHO global priority pathogens list of antibiotic-resistant bacteria - Combat AMR [Internet]. [cited 2022 Oct 31]. Available from: https://www.combatamr.org.au/news-events/who-global-priority-pathogens-list-of-antibiotic-resistant-bacteria
Mancuso G, Midiri A, Gerace E, Biondo C. Bacterial antibiotic resistance: the most critical pathogens. Pathogens. 2021;10(10):1–14.
Eun Y, Kang C in, Kyeong M, Yeon S, Mi Y, Ryeon D, et al. International Journal of Antimicrobial Agents Epidemiology and clinical outcomes of bloodstream infections caused by extended-spectrum-lactamase-producing Escherichia coli in patients with cancer. 2013;42:403–9.
Gladstone RA, McNally A, Pöntinen AK, Tonkin-Hill G, Lees JA, Skytén K, et al. Emergence and dissemination of antimicrobial resistance in Escherichia coli causing bloodstream infections in Norway in 2002–17: a nationwide, longitudinal, microbial population genomic study. The Lancet Microbe. 2021;2(7):e331–41.
de Lastours V, Laouénan C, Royer G, Carbonnelle E, Lepeule R, Esposito-Farèse M, et al. Mortality in Escherichia coli bloodstream infections: Antibiotic resistance still does not make it. J Antimicrob Chemother. 2020;75(8):2334–43.
Jubeh B, Breijyeh Z, Karaman R. Resistance of gram-positive bacteria to current antibacterial agents and overcoming approaches. Molecules. 2020;25(12).
Wu HN, Yuan EY, Li W Bin, Peng M, Zhang QY, Xie KL. Microbiological and Clinical Characteristics of Bloodstream Infections in General Intensive Care Unit: A Retrospective Study. Front Med. 2022;9(April):1–14.
Octora M, Mertaniasih NM, Semedi BP, Koendhori EB. Predictive Score Model of Clinical Outcomes Sepsis in Intensive Care Unit Tertier Referral Hospital of Eastern Indonesia. Open Access Maced J Med Sci. 2021;9(Apache Ii):1710–6.
Bonten M, Johnson JR, Van Den Biggelaar AHJ, Georgalis L, Geurtsen J, De Palacios PI, et al. Epidemiology of Escherichia coli Bacteremia: A Systematic Literature Review. Clin Infect Dis. 2021;72(7):1211–9.
Bhatt PJ, Shiau S, Brunetti L, Xie Y, Solanki K, Khalid S, et al. Risk Factors and Outcomes of Hospitalized Patients with Severe Coronavirus Disease 2019 (COVID-19) and Secondary Bloodstream Infections: A Multicenter Case-Control Study. Clin Infect Dis. 2021;72(12):E995–1003.
Liang T, Xu C, Cheng Q, Tang Y, Zeng H, Li X. Epidemiology, Risk Factors, and Clinical Outcomes of Bloodstream Infection due to Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae in Hematologic Malignancy: A Retrospective Study from Central South China. Microb Drug Resist. 2021;27(6):800–8.
Lovayová V, ÄŒurová K, Hrabovskí½ V, Nagyová M, Siegfried L, Toporová A, et al. Antibiotic Resistance in the Invasive Bacteria Escherichia Coli. Cent Eur J Public Health [Internet]. 2022;30(88):S75–80. Available from: https://doi.org/10.21101/cejph.a7384
Xiao T, Wu Z, Shi Q, Zhang X, Zhou Y, Yu X, et al. A retrospective analysis of risk factors and outcomes in patients with extended-spectrum beta-lactamase-producing Escherichia coli bloodstream infections. J Glob Antimicrob Resist [Internet]. 2019;17:147–56. Available from: https://doi.org/10.1016/j.jgar.2018.12.014
Baek YJ, Kim YA, Kim D, Shin JH, Uh Y, Shin KS, et al. Risk Factors for Extended-Spectrum- β -Lactamase- Producing Escherichia coli in Community-Onset Bloodstream Infection : Impact on Long-Term Care Hospitals in Korea. 2021;455–62.
Malande OO, Nuttall J, Pillay V, Bamford C, Eley B. A ten-year review of ESBL and non-ESBL Escherichia coli bloodstream infections among children at a tertiary referral hospital in South Africa. PLoS One. 2019;14(9):1–16.
Martinez AE, Widmer A, Frei R, Pargger H, Tuchscherer D, Marsch S, et al. ESBL-colonization at ICU admission: Impact on subsequent infection, carbapenem-consumption, and outcome. Infect Control Hosp Epidemiol. 2019;40(4):408–13.
Kawamura K, Nagano N, Suzuki M, Wachino J ichi, Kimura K, Arakawa Y. ESBL-producing Escherichia coli and Its Rapid Rise among Healthy People. Food Saf. 2017;5(4):122–50.
Bezabih YM, Sabiiti W, Alamneh E, Bezabih A, Peterson GM, Bezabhe WM, et al. The global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli in the community. J Antimicrob Chemother. 2021;76(1):22–9.
Daga AP, Koga VL, Soncini JGM, De Matos CM, Perugini MRE, Pelisson M, et al. Escherichia coli Bloodstream Infections in Patients at a University Hospital: Virulence factors and clinical characteristics. Front Cell Infect Microbiol. 2019;9(JUN).
Hawkey PM, Livermore DM. Carbapenem antibiotics for serious infections. BMJ. 2012;344(7863):1–7.
Tamma PD, Aitken SL, Bonomo RA, Mathers AJ, van Duin D, Clancy CJ. Infectious Diseases Society of America 2022 Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR- P. Clin Infect Dis. 2022;75(2):187–212.
Blandy O, Honeyford K, Gharbi M, Thomas A, Ramzan F, Ellington MJ, et al. Factors that impact on the burden of Escherichia coli bacteraemia: multivariable regression analysis of 2011–2015 data from West London. J Hosp Infect [Internet]. 2019;101(2):120–8. Available from: https://doi.org/10.1016/j.jhin.2018.10.024
Salah, Fortune Djimabi, Soubeiga ST, Ouattara AK, Sadji AY, Metuor-Dabire A, Obiri-yeboah D, Banla-kere A, et al. Distribution of quinolone resistance gene (qnr) in ESBL-producing Escherichia coli and Klebsiella spp. in Lomé , Togo. Antimicrob Resist Infect Control. 2019;8:1–8
Copyright (c) 2022 Indonesian Journal of Tropical and Infectious Disease
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Indonesian Journal of Tropical and Infectious Disease (IJTID) is a scientific peer-reviewed journal freely available to be accessed, downloaded, and used for research. All articles published in the IJTID are licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which is under the following terms:
Attribution ” You must give appropriate credit, link to the license, and indicate if changes were made. You may do so reasonably, but not in any way that suggests the licensor endorses you or your use.
NonCommercial ” You may not use the material for commercial purposes.
ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
