Incidence of community-onset extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae infections: an 11-year population-based study in Denmark.
Incidence of community-onset extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae infections: an 11-year population-based study in Denmark.
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DOI：
10.1080/23744235.2020.1763452
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发表时间：
2020-08-01
期刊：
影响因子：
--
通讯作者：
Nielsen, Henrik
中科院分区：
文献类型：
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作者：
Richelsen, Rasmus;Smit, Jesper;Nielsen, Henrik
背景资料：在低流行地区，阐明社区发病的产超广谱β-内酰胺酶（ESBL）大肠埃希菌和肺炎克雷伯菌感染趋势的数据仍然很少。我们进行了一项以人群为基础的研究，以确定社区发生的ESBL感染的发病率，时间趋势和共同耐药。埃希菌和2007-2017年期间，北丹麦地区成人患者（> 15岁）中肺炎菌血症和尿路感染。使用以人群为基础的登记，我们获得了人口统计学和收购地点的信息，并调查了社区发病ESBL感染的标准化发病率和时间趋势以及相关的共同耐药模式。coli或K.在研究期间观察到肺炎感染，2007-2017年间，年标准化发病率从每10万人年7.5例增加到105例。这一增长主要是由于E。大肠杆菌尿路感染从主要与医疗保健相关转变为社区获得性。产ESBL菌株从0.5%上升到4.0%，并有相当多的共耐药菌株。埃希菌和产ESBL的肺炎分离株在北丹麦地区显著增加。不断增加的发病率和频繁的共同耐药应提高负责经验性抗生素治疗的医生的认识。
Background: Data elucidating trends of community-onset extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae infections remain sparse in low prevalence areas. We conducted a population-based study to determine the incidence, temporal trends and co-resistance of community-onset ESBL infections.Methods: We identified all recorded episodes of E. coli and K. pneumoniae bacteraemia and urinary tract infections in adult patients (>15years) in the North Denmark Region between 2007-2017. Using population-based registries, we obtained information on demographics and place of acquisition, and investigated the standardized incidence rates and temporal trends of community-onset ESBL infections and the associated patterns of co-resistance.Results: A total of 3741 episodes of community-onset ESBL E. coli or K. pneumoniae infections were observed during the study period, with the annual standardized incidence rate increasing from 7.5 to 105 per 100,000 person-years between 2007-2017. The increase was conveyed primarily by a rise in E. coli urinary tract infections shifting from being mainly healthcare-associated to community-acquired. ESBL-producing isolates increased from 0.5 to 4.0% with considerable co-resistance.Conclusion: The proportion of E. coli and K. pneumoniae isolates producing ESBL have increased considerably in the North Denmark Region. The increasing incidence and frequent co-resistance should raise awareness among physicians responsible for empirical antibiotic treatment.