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14-Year Survey in a Swedish County Reveals a Pronounced Increase in Bloodstream Infections (BSI). Comorbidity - An Independent Risk Factor for Both BSI and Mortality.

https://arctichealth.org/en/permalink/ahliterature283680
Source
PLoS One. 2016;11(11):e0166527
Publication Type
Article
Date
2016
Author
Martin Holmbom
Christian G Giske
Mats Fredrikson
Åse Östholm Balkhed
Carina Claesson
Lennart E Nilsson
Mikael Hoffmann
Håkan Hanberger
Source
PLoS One. 2016;11(11):e0166527
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Anti-Bacterial Agents - therapeutic use
Bacteremia - drug therapy - epidemiology - microbiology - mortality
Candidiasis - drug therapy - epidemiology - microbiology - mortality
Community-Acquired Infections
Comorbidity
Cross Infection - epidemiology - microbiology
Female
Fungemia - drug therapy - epidemiology - microbiology - mortality
Gram-Negative Bacterial Infections - drug therapy - epidemiology - microbiology - mortality
Gram-Positive Bacterial Infections - drug therapy - epidemiology - microbiology - mortality
Health Surveys
Humans
Male
Middle Aged
Multivariate Analysis
Retrospective Studies
Risk factors
Survival Analysis
Sweden - epidemiology
Abstract
we assessed the incidence, risk factors and outcome of BSI over a 14-year period (2000-2013) in a Swedish county.
retrospective cohort study on culture confirmed BSI among patients in the county of Östergötland, Sweden, with approximately 440,000 inhabitants. A BSI was defined as either community-onset BSI (CO-BSI) or hospital-acquired BSI (HA-BSI).
of a total of 11,480 BSIs, 67% were CO-BSI and 33% HA-BSI. The incidence of BSI increased by 64% from 945 to 1,546 per 100,000 hospital admissions per year during the study period. The most prominent increase, 83% was observed within the CO-BSI cohort whilst HA-BSI increased by 32%. Prescriptions of antibiotics in outpatient care decreased with 24% from 422 to 322 prescriptions dispensed/1,000 inhabitants/year, whereas antibiotics prescribed in hospital increased by 67% (from 424 to 709 DDD per 1,000 days of care). The overall 30-day mortality for HA-BSIs was 17.2%, compared to 10.6% for CO-BSIs, with an average yearly increase per 100,000 hospital admissions of 2 and 5% respectively. The proportion of patients with one or more comorbidities, increased from 20.8 to 55.3%. In multivariate analyses, risk factors for mortality within 30 days were: HA-BSI (2.22); two or more comorbidities (1.89); single comorbidity (1.56); CO-BSI (1.21); male (1.05); and high age (1.04).
this survey revealed an alarming increase in the incidence of BSI over the 14-year study period. Interventions to decrease BSI in general should be considered together with robust antibiotic stewardship programmes to avoid both over- and underuse of antibiotics.
Notes
Cites: Infect Control Hosp Epidemiol. 2009 Nov;30(11):1036-4419780675
Cites: Am J Infect Control. 2016 Feb;44(2):167-7226577629
Cites: APMIS. 1999 Mar;107(3):346-5210223308
Cites: Scand J Infect Dis. 2010;42(2):90-619902992
Cites: PLoS One. 2015 May 06;10(5):e012582725946168
Cites: Proc Assoc Am Physicians. 1997 Jan;109(1):58-679010917
Cites: Clin Microbiol Infect. 2011 Mar;17(3):451-820491834
Cites: Crit Care. 2006;10(2):R4216542492
Cites: Crit Care. 2015 Aug 28;19:28626316210
Cites: Crit Care Med. 2014 Mar;42(3):625-3124201173
Cites: Crit Care Med. 2013 May;41(5):1167-7423442987
Cites: J Antimicrob Chemother. 2011 Dec;66 Suppl 6:vi3-1222096064
Cites: JAMA. 2009 Dec 2;302(21):2323-919952319
Cites: Ups J Med Sci. 2014 May;119(2):154-6124724823
Cites: NCHS Data Brief. 2011 Jun;(62):1-822142805
Cites: J Hosp Infect. 2010 Jul;75(3):158-6220381900
Cites: Arch Intern Med. 2007 Apr 23;167(8):834-917452548
Cites: Clin Infect Dis. 2011 Jan 1;52(1):61-921148521
Cites: Lancet Infect Dis. 2012 Jun;12(6):480-722632186
Cites: Expert Rev Anti Infect Ther. 2012 Jun;10(6):701-622734959
Cites: Eur J Clin Microbiol Infect Dis. 1988 Aug;7(4):501-43141157
Cites: Clin Microbiol Infect. 2013 Jun;19(6):501-923473333
Cites: Medicine (Baltimore). 2008 Jul;87(4):234-4918626306
Cites: Clin Microbiol Infect. 2012 Jun;18(6):E170-622512663
Cites: Epidemiol Infect. 2008 Jan;136(1):108-1417335630
Cites: Syst Rev. 2015 Sep 23;4:11926394931
Cites: J Am Geriatr Soc. 2014 Feb;62(2):306-1124438554
Cites: N Engl J Med. 2001 Nov 8;345(19):1368-7711794169
Cites: N Engl J Med. 2003 Apr 17;348(16):1546-5412700374
Cites: Clin Infect Dis. 2004 Aug 1;39(3):309-1715306996
Cites: Clin Infect Dis. 2013 Mar;56(6):798-80523223600
Cites: Open Forum Infect Dis. 2015 Oct 26;2(4):ofv16126634220
Cites: Clin Microbiol Infect. 2010 Sep;16(9):1408-1319845694
Cites: JAMA. 2016 Feb 23;315(8):801-1026903338
Cites: Crit Care Med. 2013 Feb;41(2):580-63723353941
Cites: Scand J Prim Health Care. 2009;27(1):18-2419085427
PubMed ID
27835663 View in PubMed
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High frequency of co-resistance in CTX-M-producing Escherichia coli to non-beta-lactam antibiotics, with the exceptions of amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin, in a county of Sweden.

https://arctichealth.org/en/permalink/ahliterature119319
Source
Scand J Infect Dis. 2013 Apr;45(4):271-8
Publication Type
Article
Date
Apr-2013
Author
Åse Östholm Balkhed
Maria Tärnberg
Hans-Jürg Monstein
Anita Hällgren
Håkan Hanberger
Lennart E Nilsson
Author Affiliation
Clinical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Source
Scand J Infect Dis. 2013 Apr;45(4):271-8
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - pharmacology
Drug Resistance, Bacterial
Escherichia coli - drug effects - enzymology - isolation & purification
Escherichia coli Infections - epidemiology - microbiology
Humans
Microbial Sensitivity Tests
Statistics, nonparametric
Sweden - epidemiology
beta-Lactamases - biosynthesis
Abstract
The objective of this study was to investigate the in vitro activity of different antibiotics against CTX-M-producing Escherichia coli in a county of Sweden, and to determine the occurrence of multi-resistance and plasmid- mediated quinolone resistance among these isolates.
A total of 198 isolates of E. coli with extended-spectrum beta-lactamase (ESBL) phenotype and mainly CTX-M genotype were studied. The minimum inhibitory concentrations (MICs) for amikacin, chloramphenicol, ciprofloxacin, colistin, fosfomycin, gentamicin, nalidixic acid, nitrofurantoin, tigecycline, tobramycin, trimethoprim, and trimethoprim-sulfamethoxazole were determined with the Etest. Susceptibility was defined according to the breakpoints of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). MIC50 and MIC90 values were calculated.
Ninety-five percent or more of the isolates were susceptible to amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. CTX-M group 9 was more susceptible than CTX-M group 1 to ciprofloxacin, gentamicin, and tobramycin. Sixty-eight percent of the isolates were multi-resistant, and the most common multi-resistance pattern was ESBL phenotype with decreased susceptibility to trimethoprim, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and tobramycin. Only 1 isolate carried a qnrS1 gene, but 37% carried aac(6')-Ib-cr.
A high frequency of co-resistance between ESBL-producing E. coli and non-beta-lactam antibiotics was seen. On the other hand, very high susceptibility was seen for amikacin, nitrofurantoin, colistin, tigecycline, and fosfomycin. These data support the replacement of gentamicin and tobramycin, normally used in Sweden, with amikacin, for severe infections.
PubMed ID
23113731 View in PubMed
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Prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae and trends in antibiotic consumption in a county of Sweden.

https://arctichealth.org/en/permalink/ahliterature142333
Source
Scand J Infect Dis. 2010 Dec;42(11-12):831-8
Publication Type
Article
Date
Dec-2010
Author
Ase Ostholm-Balkhed
Maria Tärnberg
Maud Nilsson
Anita V Johansson
Håkan Hanberger
Hans-Jürg Monstein
Lennart E Nilsson
Author Affiliation
Department of Infectious Diseases, University Hospital Linköping, Linköping, Sweden. ase.ostholm-balkhed@lio.se
Source
Scand J Infect Dis. 2010 Dec;42(11-12):831-8
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - pharmacology - therapeutic use
Child
Child, Preschool
Drug Utilization - statistics & numerical data
Enterobacteriaceae - drug effects - enzymology - isolation & purification
Enterobacteriaceae Infections - epidemiology - microbiology
Female
Humans
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Middle Aged
Prevalence
Sweden - epidemiology
Young Adult
beta-Lactamases - biosynthesis
beta-Lactams - pharmacology - therapeutic use
Abstract
In the last decade extended-spectrum beta-lactamase (ESBL)-producing bacteria have become an increasing problem. Our aims were to investigate the prevalence of ESBL-producing Enterobacteriaceae and trends in antibiotic use in the county of Östergötland, Sweden. From 2002 through 2007 there were 224 ESBL-producing Escherichia coli and 23 Klebsiella pneumoniae isolates with an ESBL-phenotype identified among all Enterobacteriaceae isolated at the clinical laboratory. Trends in antibiotic consumption expressed as defined daily doses (DDD) per 1000 inhabitants and day (DID) were studied. The prevalence of ESBL-producing isolates among Enterobacteriaceae in our region is still low (
PubMed ID
20608768 View in PubMed
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Travel-associated faecal colonization with ESBL-producing Enterobacteriaceae: incidence and risk factors.

https://arctichealth.org/en/permalink/ahliterature113873
Source
J Antimicrob Chemother. 2013 Sep;68(9):2144-53
Publication Type
Article
Date
Sep-2013
Author
Ase Ostholm-Balkhed
Maria Tärnberg
Maud Nilsson
Lennart E Nilsson
Håkan Hanberger
Anita Hällgren
Author Affiliation
Infectious Diseases, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Source
J Antimicrob Chemother. 2013 Sep;68(9):2144-53
Date
Sep-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cohort Studies
Enterobacteriaceae - enzymology - genetics - isolation & purification
Enterobacteriaceae Infections - epidemiology - microbiology
Feces - microbiology
Female
Genotype
Humans
Incidence
Male
Microbial Sensitivity Tests
Middle Aged
Phenotype
Prospective Studies
Questionnaires
Risk factors
Sweden - epidemiology
Travel
Young Adult
beta-Lactamases - genetics - secretion
Abstract
To study the acquisition of extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) among the faecal flora during travel, with a focus on risk factors, antibiotic susceptibility and ESBL-encoding genes.
An observational prospective multicentre cohort study of individuals attending vaccination clinics in south-east Sweden was performed, in which the submission of faecal samples and questionnaires before and after travelling outside Scandinavia was requested. Faecal samples were screened for ESBL-PE by culturing on ChromID ESBL and an in-house method. ESBL-PE was confirmed by phenotypic and genotypic methods. Susceptibility testing was performed with the Etest. Individuals who acquired ESBL-PE during travel (travel-associated carriers) were compared with non-carriers regarding risk factors, and unadjusted and adjusted ORs after manual stepwise elimination were calculated using logistic regression.
Of 262 enrolled individuals, 2.4% were colonized before travel. Among 226 evaluable participants, ESBL-PE was detected in the post-travel samples from 68 (30%) travellers. The most important risk factor in the final model was the geographic area visited: Indian subcontinent (OR 24.8, P?
PubMed ID
23674762 View in PubMed
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