Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly
We conducted a survey including 3,334 bloodstream infections (BSIs) due to E. coli diagnosed in 2005-2014 at a stable cohort of hospitals. Marked increases in incidence were observed for community-acquired (CA) BSIs in patients aged >75 years, CA-BSIs of digestive origin in patients aged 60-74 ye...
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Frontiers Media S.A.
2015-06-01
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Series: | Frontiers in Microbiology |
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Online Access: | http://journal.frontiersin.org/Journal/10.3389/fmicb.2015.00646/full |
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author | Nathalie Laure Van Der Mee-Marquet Dominique S. Blanc Houssein eGbaguidi-Haore Sandra eDos santos Borges Quentin eViboud Xavier eBertrand Roland eQuentin |
author_facet | Nathalie Laure Van Der Mee-Marquet Dominique S. Blanc Houssein eGbaguidi-Haore Sandra eDos santos Borges Quentin eViboud Xavier eBertrand Roland eQuentin |
author_sort | Nathalie Laure Van Der Mee-Marquet |
collection | DOAJ |
description | We conducted a survey including 3,334 bloodstream infections (BSIs) due to E. coli diagnosed in 2005-2014 at a stable cohort of hospitals. Marked increases in incidence were observed for community-acquired (CA) BSIs in patients aged >75 years, CA-BSIs of digestive origin in patients aged 60-74 years, healthcare-associated BSIs, and BSIs associated with ESBL (extended-spectrum B-lactamase)-producing E. coli (ESBLEc). Using MLST, we studied the genetic diversity of 412 BSI isolates recovered during the 2014 survey: 7 major sequence type complexes (STCs) were revealed in phylogenetic group B2, 3 in group A/B1 and 2 in group D. Among the 31 ESBLEc isolates, 1/3 belonged to STC 131. We searched for possible associations between clonal groups, clinical determinants and characteristics of BSIs: isolates from groups B2 (except STC 131) and D were susceptible to antibiotics and associated with BSIs of urinary origin in patients <60 years. STC 131 and group A/B1 isolates were multi-drug resistant and associated with CA-BSIs of digestive origin in patients aged 60-74 with a recent history of antibiotic treatment. STC 131 isolates were associated with HCA-BSIs in patients with recent/present hospitalization in a long-stay unit. We provide a unique population-based picture of the epidemiology of E. coli BSI. The aging nature of the population led to an increase in the number of cases caused by the B2 and D isolates generally implicated in BSIs. In addition, the association of a trend towards increasing rates of gut colonization with multi drug-resistant isolates revealed by the rise in the incidence of BSIs of digestive origin caused by STC 131 and A/B1 (STCs 10, 23 and 155) isolates, and a significant increase in the frequency of BSIs in elderly patients with recent antibiotic treatment suggested that antibiotic use may have contributed to the growing incidence of BSI. |
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issn | 1664-302X |
language | English |
last_indexed | 2024-12-13T03:08:02Z |
publishDate | 2015-06-01 |
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spelling | doaj.art-556d49693b6a415fbe4341e1fe611d042022-12-22T00:01:40ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2015-06-01610.3389/fmicb.2015.00646150950Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderlyNathalie Laure Van Der Mee-Marquet0Dominique S. Blanc1Houssein eGbaguidi-Haore2Sandra eDos santos Borges3Quentin eViboud4Xavier eBertrand5Roland eQuentin6Centre Hospitalier Universitaire de ToursLausanne University HospitalCentre Hospitalier Universitaire de BesançonCentre Hospitalier Universitaire de ToursCentre Hospitalier Universitaire de ToursCentre Hospitalier Universitaire de BesançonCentre Hospitalier Universitaire de ToursWe conducted a survey including 3,334 bloodstream infections (BSIs) due to E. coli diagnosed in 2005-2014 at a stable cohort of hospitals. Marked increases in incidence were observed for community-acquired (CA) BSIs in patients aged >75 years, CA-BSIs of digestive origin in patients aged 60-74 years, healthcare-associated BSIs, and BSIs associated with ESBL (extended-spectrum B-lactamase)-producing E. coli (ESBLEc). Using MLST, we studied the genetic diversity of 412 BSI isolates recovered during the 2014 survey: 7 major sequence type complexes (STCs) were revealed in phylogenetic group B2, 3 in group A/B1 and 2 in group D. Among the 31 ESBLEc isolates, 1/3 belonged to STC 131. We searched for possible associations between clonal groups, clinical determinants and characteristics of BSIs: isolates from groups B2 (except STC 131) and D were susceptible to antibiotics and associated with BSIs of urinary origin in patients <60 years. STC 131 and group A/B1 isolates were multi-drug resistant and associated with CA-BSIs of digestive origin in patients aged 60-74 with a recent history of antibiotic treatment. STC 131 isolates were associated with HCA-BSIs in patients with recent/present hospitalization in a long-stay unit. We provide a unique population-based picture of the epidemiology of E. coli BSI. The aging nature of the population led to an increase in the number of cases caused by the B2 and D isolates generally implicated in BSIs. In addition, the association of a trend towards increasing rates of gut colonization with multi drug-resistant isolates revealed by the rise in the incidence of BSIs of digestive origin caused by STC 131 and A/B1 (STCs 10, 23 and 155) isolates, and a significant increase in the frequency of BSIs in elderly patients with recent antibiotic treatment suggested that antibiotic use may have contributed to the growing incidence of BSI.http://journal.frontiersin.org/Journal/10.3389/fmicb.2015.00646/fullEscherichia coliElderlyantibioticBloodstream infectionST 131 |
spellingShingle | Nathalie Laure Van Der Mee-Marquet Dominique S. Blanc Houssein eGbaguidi-Haore Sandra eDos santos Borges Quentin eViboud Xavier eBertrand Roland eQuentin Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly Frontiers in Microbiology Escherichia coli Elderly antibiotic Bloodstream infection ST 131 |
title | Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly |
title_full | Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly |
title_fullStr | Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly |
title_full_unstemmed | Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly |
title_short | Marked increase in incidence for bloodstream infections due to Escherichia coli, a side effect of previous antibiotic therapy in the elderly |
title_sort | marked increase in incidence for bloodstream infections due to escherichia coli a side effect of previous antibiotic therapy in the elderly |
topic | Escherichia coli Elderly antibiotic Bloodstream infection ST 131 |
url | http://journal.frontiersin.org/Journal/10.3389/fmicb.2015.00646/full |
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