Resistance trend, antibiotic utilization and mortality in patients with E. Coli bacteraemia

Amirreza Najmi, Fateme Karimi, Vijayanarayan Kunhikatta, Muralidhar Varma, Sreedharan Nair

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Incidence of bacteraemia and driving concerns about antibiotic resistance is increasing globally. Risk factors for developing antimicrobial resistance are antibiotic overuse, incorrect dosing and extended duration of administration. AIM: This study was conducted to examine the prescription and susceptibility pattern of antibiotics in bacteraemia patients with ESBL producing and Non-ESBL-producing E. coli and their correlation with mortality. METHODS: Data were collected from medical records of the patients aged 18 years and above, diagnosed with E. coli bacteremia from January 2013 through July 2017. Institutional ethics committee approval was obtained before the study (IEC 483/2017). Cumulative sensitivity/resistance pattern of isolated microorganisms and DDD/100 bed days of prescribed antibiotics were obtained. RESULTS: 182 cases of E. coli bacteraemia were reviewed. 59.9% (n = 109) were male with an age range of 20-90 years. The mortality rate was 24.9% (n = 44). 55.5% (n = 101) of the isolated organisms were ESBL-producing. A high percentage of resistance to cephalosporins and fluoroquinolones were observed among the patients, and most of the identified isolates were sensitive to the aminoglycosides, carbapenems and β-lactam and β-lactamase inhibitor combinations (BLBLIs). CONCLUSIONS: Frequent utilisation of the high-end antibiotics and increase in microorganism’s resistance to different antibiotics can lead to a worrisome level. Local antibiotic resistance data and consumption policy are essential to prevent and slow down this process. We observed a descending resistance trend for amoxicillin-clavulanic acid combination in our setting to both the ESBL producing and non-producing.

Original languageEnglish
Pages (from-to)1119-1123
Number of pages5
JournalOpen Access Macedonian Journal of Medical Sciences
Volume7
Issue number7
DOIs
Publication statusPublished - 15-04-2019

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Microbial Drug Resistance
Bacteremia
Escherichia coli
Anti-Bacterial Agents
Mortality
Cephalosporin Resistance
Dichlorodiphenyldichloroethane
Amoxicillin-Potassium Clavulanate Combination
Lactams
Ethics Committees
Carbapenems
Fluoroquinolones
Aminoglycosides
Medical Records
Prescriptions
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

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title = "Resistance trend, antibiotic utilization and mortality in patients with E. Coli bacteraemia",
abstract = "BACKGROUND: Incidence of bacteraemia and driving concerns about antibiotic resistance is increasing globally. Risk factors for developing antimicrobial resistance are antibiotic overuse, incorrect dosing and extended duration of administration. AIM: This study was conducted to examine the prescription and susceptibility pattern of antibiotics in bacteraemia patients with ESBL producing and Non-ESBL-producing E. coli and their correlation with mortality. METHODS: Data were collected from medical records of the patients aged 18 years and above, diagnosed with E. coli bacteremia from January 2013 through July 2017. Institutional ethics committee approval was obtained before the study (IEC 483/2017). Cumulative sensitivity/resistance pattern of isolated microorganisms and DDD/100 bed days of prescribed antibiotics were obtained. RESULTS: 182 cases of E. coli bacteraemia were reviewed. 59.9{\%} (n = 109) were male with an age range of 20-90 years. The mortality rate was 24.9{\%} (n = 44). 55.5{\%} (n = 101) of the isolated organisms were ESBL-producing. A high percentage of resistance to cephalosporins and fluoroquinolones were observed among the patients, and most of the identified isolates were sensitive to the aminoglycosides, carbapenems and β-lactam and β-lactamase inhibitor combinations (BLBLIs). CONCLUSIONS: Frequent utilisation of the high-end antibiotics and increase in microorganism’s resistance to different antibiotics can lead to a worrisome level. Local antibiotic resistance data and consumption policy are essential to prevent and slow down this process. We observed a descending resistance trend for amoxicillin-clavulanic acid combination in our setting to both the ESBL producing and non-producing.",
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Resistance trend, antibiotic utilization and mortality in patients with E. Coli bacteraemia. / Najmi, Amirreza; Karimi, Fateme; Kunhikatta, Vijayanarayan; Varma, Muralidhar; Nair, Sreedharan.

In: Open Access Macedonian Journal of Medical Sciences, Vol. 7, No. 7, 15.04.2019, p. 1119-1123.

Research output: Contribution to journalArticle

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AU - Karimi, Fateme

AU - Kunhikatta, Vijayanarayan

AU - Varma, Muralidhar

AU - Nair, Sreedharan

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