Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: Sheriff EA[original query] |
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Antibiotic multi-drug-resistance of Escherichia coli causing device- and procedure-related infections in the United States reported to the National Healthcare Safety Network (NHSN), 2013-2017
Kourtis AP , Sheriff EA , Weiner-Lastinger LM , Elmore K , Preston LE , Dudeck M , McDonald LC . Clin Infect Dis 2020 73 (11) e4552-e4559 BACKGROUND: Escherichia coli is one of the most common causes of healthcare-associated infections (HAI); multidrug resistance reduces available options for antibiotic treatment. We examined factors associated with the spread of multidrug-resistant E. coli phenotypes responsible for device- and procedure-related HAI from acute care hospitals, long term acute care hospitals and inpatient rehabilitation facilities, using isolate and antimicrobial susceptibility data reported to the National Healthcare Safety Network (NHSN) from 2013-2017. METHODS: We used multivariable logistic regression to examine associations between co-resistant phenotypes, patient and healthcare facility characteristics, and time. We also examined the geographic distributione of co-resistant phenotypes each year by state and by hospital referral region to identify hot spots. RESULTS: A total of 96,672 E. coli isolates were included. Patient median age was 62 years; 60% were females; over half (54%) were reported from catheter-associated urinary tract infections. From 2013-2017, 35% of the isolates were non-susceptible to FQs; 17% to ESCs; and 13% to both ESCs and FQs. The proportion of isolates co-resistant to ESCs and FQs was higher in 2017 (14%) than in 2013 (11%) (P<0.0001); overall prevalence and increases were heterogeneously distributed across healthcare referral regions. Co-resistance to FQs and ESCs was independently associated with male sex, central line-associated bloodstream infections, long-term acute care hospitals, and the 2016-17 (v. 2013-14) reporting period. CONCLUSIONS: Multidrug-resistance among E.coli causing device- and procedure-related HAIs has increased in the United States. FQ and ESC co-resistant strains appear to be spreading heterogeneously across hospital referral regions. |
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