Escherichia coli belonging to the worldwide emerging epidemic clonal group O25b/ST131: risk factors and clinical implications
| Autor: | Lorena López-Cerero, Laura Viñas, Álvaro Pascual, Sara Louise Gómez-Langley, Isabel Fernández Morales, Almudena Martín-Peña, Jesús Rodríguez-Baño, Herminia Sánchez-Monteseirín, María Dolores Navarro, José Miguel Cisneros, Mar Bellido |
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| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Adolescent Genotype medicine.drug_class Antibiotics Virulence Biology medicine.disease_cause beta-Lactamases Sepsis Young Adult Antibiotic resistance Risk Factors Internal medicine medicine Escherichia coli Humans Pharmacology (medical) Risk factor Epidemics Escherichia coli Infections Aged Pharmacology Aged 80 and over Amoxicillin Middle Aged medicine.disease Survival Analysis Molecular Typing Infectious Diseases Spain Bacteremia Immunology Female medicine.drug |
| Zdroj: | The Journal of antimicrobial chemotherapy. 69(3) |
| ISSN: | 1460-2091 |
| Popis: | Objectives Escherichia coli belonging to clonal group ST131 has emerged as a significant contributor to infection caused by antibiotic-resistant E. coli worldwide. We investigated the risk factors for infections caused by ST131 E. coli and their clinical implications. Methods One thousand and seventy-seven E. coli isolates were screened for ST131 by molecular methods. Risk factors for ST131 were investigated separately for patients with E. coli producing and not producing extended-spectrum β-lactamases (ESBLs) in the Seville area, Spain. Multivariate analysis using logistic regression was performed. Patients with infections caused by ST131 and non-ST131 isolates were prospectively followed. Results Independent risk factors for non-ESBL-producing ST131 were female gender (OR: 1.94; 95% CI: 1.07-3.51), diabetes mellitus (OR: 2.17; 95% CI: 1.29-3.67), bedridden status (OR: 7.75; 95% CI: 0.70-85.07) and exposure to amoxicillin/clavulanate (OR: 2.07; 95% CI: 1.08-3.96) or fluoroquinolones (OR: 2.48; 95% CI: 1.41-4.34). For ESBL-producing ST131, male gender was an independent risk factor (OR: 2.20; 95% CI: 0.94-5.11), while healthcare-related acquisition and exposure to any previous antibiotic were protective (OR: 0.30; 95% CI: 0.13-0.71; and OR: 0.43; 95% CI: 0.19-1.00, respectively). Overall, the severity of sepsis, bacteraemia and mortality were similar among ST131 and non-ST131 groups. The presence of typical factors predisposing to E. coli infection was more frequent in non-ESBL-producing ST131 than in controls (76% versus 57.2%, P = 0.005). Conclusions Previous use of antibiotics selecting for ST131 isolates was the main modifiable risk factor for infections caused by these isolates. Our results also suggest that the clinical virulence of ST131 is not higher than that of other common E. coli causing infections. |
| Databáze: | OpenAIRE |
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