Nosocomial bloodstream infections caused by Escherichia coli and Klebsiellapneumoniae resistant to third-generation cephalosporins, Finland, 1999–2013: Trends, patient characteristics and mortality. Issue 3 (3rd March 2016)

• Record Type: Journal Article
• Authors: Martelius, Timi; Jalava, Jari; Kärki, Tommi; Möttönen, Teemu; Ollgren, Jukka; Lyytikäinen, Outi
• Is Part Of: Infectious diseases. Volume 48:Issue 3(2016:Mar.)
• Page Start: 229
• Page End: 234
• Publication Date: 2016-03-03
• Subjects: Nosocomial -- blood stream infection -- surveillance -- ESBL; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.3109/23744235.2015.1109135
• Languages: English
• ISSNs: 2374-4235

Abstract

Abstract: Background : Few systematically collected multi-centre surveillance data on nosocomial bloodstream infections (BSI) caused by extended-spectrum β -lactamase (ESBL) producing Escherichia coli or Klebsiella pneumoniae have been published. Aim : To evaluate trends, patient characteristics and mortality of such infections, nosocomial BSI data reported by the 4–17 hospitals participating in the prospective laboratory-based surveillance during 1999–2013 were analysed. Methods : Data were collected by local infection control nurses, patient-days were obtained from the hospital's administrative database, and dates of deaths from the population registry. Resistance to third-generation cephalosporins was further examined in the national reference laboratory. Findings : A total of 16 028 nosocomial BSIs were identified; 2217 (14%) were caused by E. coli and 661 (4%) by K. pneumoniae ; 207 (7%) were non-susceptible to third-generation cephalosporins, with an increasing trend from 0% in 1999 to 17% in 2013. Patient characteristics did not differ significantly between BSIs caused by third-generation susceptible and resistant E. coli and K. pneumonia, but the case fatality tended to be higher. Most (88%) of the isolates reported as non-susceptible to third-generation cephalosporins had ESBL phenotype, CTX-M (79%) being the most common enzyme. Conclusion : A sharp increase in nosocomial BSIs caused by ESBL producing bacteria was observed. Identification of patients for screening pose a challenge, emphasising the role of infection control guidelines and antibiotic policy in prevention