Epidemiology, risk factors and antimicrobial resistance of Escherichia coli bacteremia

Mahjuba Umme Salam, Selina Yasmin, Md. Rashedul Haque, Sharmin Ahmed, Shahidul Alam, Mashuq Ahmad Jumma, Abu Saleh Shimon
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Abstract

Background: Escherichia coli is a common causative of blood stream infection having potentials to produce significant morbidity and mortality. This organism also has the ability to develop resistance against antimicrobial agents. Knowing its epidemiology, risk factors and antimicrobial resistance patterns can help preventing and managing bacteremia caused by this organism. Materials and methods: This was across sectional observational study carried out from February 2017 to February 2018 on 64 blood culture positive Escherichia coli infected patients admitted in Medicine inpatient of a medical college hospital. Age, sex, mode of acquisition of infection, history of prior empiric antibiotic treatment, duration of hospital stay, development of complication were observed and noted. Antibiotic susceptibility test for all isolates was performed by Kirby-Bauer disc diffusion method. Predesigned semi-structured data collection from was used and collected data were analyzed manually and expressed in descriptive statistical terms. Results: Of the 64 enrolled patients, 47(73.43%) were female. Average age of affection was 53.48±20.65 years and increased incidence rates (51.56%) was observed at age >60 years. Infection was communityacquired in 35.84% cases and urinary tract infection was the most frequent (46.3) risk factor. More than eighty seven percent of samples showed resistance to at least one antimicrobial agent and resistance to multiple drugs was associated with complications. Conclusion: Escherichia coli bacteremia has high incidence rates for antimicrobial resistance and mortality. Continuous surveillance and antibiotic susceptibility pattern monitoring is essential to develop regional antibiotic therapy protocols.
大肠杆菌血症的流行病学、危险因素及耐药性
背景:大肠杆菌是一种常见的引起血流感染的病原体,有可能产生显著的发病率和死亡率。这种微生物也有能力对抗菌剂产生耐药性。了解其流行病学、危险因素和抗微生物药物耐药性模式有助于预防和管理由这种微生物引起的菌血症。材料与方法:本研究于2017年2月至2018年2月对某医学院附属医院内科住院的64例血培养阳性大肠杆菌感染患者进行横断面观察性研究。观察并记录年龄、性别、感染方式、既往经验性抗生素治疗史、住院时间、并发症发生情况。采用Kirby-Bauer圆盘扩散法对各菌株进行药敏试验。使用预先设计的半结构化数据收集,收集的数据进行人工分析并以描述性统计术语表示。结果:64例入组患者中,女性47例(73.43%)。平均发病年龄为53.48±20.65岁,60 ~ 60岁发病率增高(51.56%)。社区获得性感染占35.84%,尿路感染是最常见的危险因素(46.3%)。超过87%的样本显示出对至少一种抗菌剂的耐药性,对多种药物的耐药性与并发症有关。结论:大肠杆菌血症具有较高的耐药发生率和死亡率。持续监测和抗生素敏感性模式监测对于制定区域抗生素治疗方案至关重要。
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