Back to Search
Start Over
High Burden of Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Bacteremia in Older Adults: A Seven-Year Study in Two Rural Thai Provinces.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2019 Apr; Vol. 100 (4), pp. 943-951. - Publication Year :
- 2019
-
Abstract
- Bloodstream infection surveillance conducted from 2008 to 2014 in all 20 hospitals in Sa Kaeo and Nakhon Phanom provinces, Thailand, allowed us to look at disease burden, antibiotic susceptibilities, and recurrent infections caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae . Of 97,832 blood specimens, 3,338 were positive for E. coli and 1,086 for K. pneumoniae . The proportion of E. coli isolates producing ESBL significantly increased from 19% to 22% in 2008-2010 to approximately 30% from 2011 to 2014 ( P -value for trend = 0.02), whereas ESBL production among K. pneumoniae cases was 27.4% with no significant trend over time. Incidence of community-onset ESBL-producing E. coli increased from 5.4 per 100,000 population in 2008 to 12.8 in 2014, with the highest rates among persons aged ≥ 70 years at 79 cases per 100,000 persons in 2014. From 2008 to 2014, community-onset ESBL-producing K. pneumoniae incidence was 2.7 per 100,000, with a rate of 12.9 among those aged ≥ 70 years. Although most (93.6% of E. coli and 87.6% of K. pneumoniae ) infections were community-onset, hospital-onset infections were twice as likely to be ESBL. Population-based surveillance, as described, is vital to accurately monitor emergence and trends in antimicrobial resistance, and in guiding the development of rational antimicrobial therapy recommendations.
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Cross Infection epidemiology
Cross Infection microbiology
Escherichia coli enzymology
Escherichia coli genetics
Female
Humans
Infant
Infant, Newborn
Klebsiella pneumoniae enzymology
Klebsiella pneumoniae genetics
Male
Middle Aged
Risk Factors
Thailand epidemiology
Young Adult
beta-Lactamases
Bacteremia epidemiology
Epidemiological Monitoring
Escherichia coli Infections epidemiology
Klebsiella Infections epidemiology
Rural Population statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 100
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 30793684
- Full Text :
- https://doi.org/10.4269/ajtmh.18-0394