Risk factors and molecular epidemiology of community-onset, multidrug resistance extended-spectrum beta-lactamase-producing Escherichia coli infectionsopen access
- Authors
- Park, SY[Park, So Yeon]; Kang, CI[Kang, Cheol-In]; Wi, YM[Wi, Yu Mi]; Chung, DR[Chung, Doo Ryeon]; Peck, KR[Peck, Kyong Ran]; Lee, NY[Lee, Nam-Yong]; Song, JH[Song, Jae-Hoon]
- Issue Date
- Jan-2017
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Drug resistance, multiple; Extended-spectrum beta-lactamase; Escherichia coli; Community-onset infection
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.32, no.1, pp.146 - 157
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 32
- Number
- 1
- Start Page
- 146
- End Page
- 157
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/30557
- DOI
- 10.3904/kjim.2015.113
- ISSN
- 1226-3303
- Abstract
- Background/Aims: Although multidrug resistance (MDR) among extended-spectrum beta-lactamase-producing Escherichia coli (ESBL-EC) poses significant therapeutic challenges, little is known regarding the risk factors and epidemiology of community-onset MDR-ESBL-EC infections. We performed this study to investigate risk factors and the molecular epidemiology of community-onset MDR-ESBL-EC infections. Methods: We conducted a case-control-control study of community-onset infections. MDR-ESBL-EC was defined as ESBL-EC that demonstrated in vitro resistance to trimethoprim-sulfamethoxazole, fluoroquinolones (FQs), and gentamicin. Patients with MDR-ESBL-EC infections were designated as case patients. A control group I (CG I) patient was defined as a person whose clinical sample yielded ESBL-EC that did not meet the criteria for MDR. A control group II (CG II) patient was defined as a patient with a non-ESBL-EC infection. Results: Of 108 patients with ESBL-EC infections, 30 cases (27.8%) were due to MDR-ESBL-EC. Compared with CG I, prior use of FQs (odds ratio [OR], 3.16; 95% confidence interval [CI], 1.11 to 8.98) and immunosuppressant use (OR, 10.47; 95% CI, 1.07 to 102.57) were significantly associated with MDR-ESBL-EC. Compared with CG II, prior use of FQs (OR, 15.53; 95% CI, 2.86 to 84.27) and healthcare-associated infection (OR, 5.98; 95% CI, 2.26 to 15.86) were significantly associated with MDR-ESBL-EC. CTX-M-15 was the most common in MDR-ESBL-EC infections (59.1% [13/22]), while CTX-M-14 was the most common in non-MDR-ESBL-EC infections (41.6% [32/77]). CTX-M-15 was significantly associated with MDR-ESBL-EC (59.1% vs. 32.5%, p = 0.028). Pulsed-field gel electrophoresis showed clonal diversity of MDR-ESBL-EC isolates. Conclusions: The emergence of strains of MDR-ESBL-EC in the community poses an important new public health threat. More information on the emergence and transmission of these strains will be necessary in order to prevent their spread.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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