Antibiotic-resistant Escherichia coli (E. coli) continues to proliferate, driven largely by expansion of a strain of E. coli know as sequence type ST131. A new study points to hospitals and long-term care facilities (LTCF) as settings in which this antibiotic-resistant strain is increasingly found. The study is published in the April issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
E. coli is the most common gram-negative pathogen, causing both gastrointestinal disease and extraintestinal infections such as pneumonia, meningitis, and bloodstream, urinary tract, abdominal, and wound infections. Strains of E. coli that are resistant to single or multiple classes of antibiotics are becoming more prevalent. E. coli ST131 is commonly associated with fluoroquinolone resistance.
"The expansion of E. coli strain ST131 is recognized as a pandemic, but has received comparatively little attention in the United States," said Ritu Banerjee, lead investigator of the study. "Alarmingly, the pace of new antibiotic development has not kept up with the emergence of antibiotic-resistant E. coli, making development of strategies to halt further emergence and spread of these strains a public health priority."
In this retrospective study, investigators evaluated nearly 300 consecutive patients in Olmsted County, Minnesota with extraintestinal E. coli infections and found ST131 to be a dominant, antimicrobial-resistant clonal group associated with older age, long-term care facility residence, complicated infections, history of urinary tract infection, and prior antimicrobial use.
LTCF residence was the strongest predictor of ST131 infection, with LTCF residents having 8 times the risk of contracting E. coli ST131 compared with non-LTCF residents. This trend coincides with the increasing preval
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Society for Healthcare Epidemiology of America