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- W2884676598 abstract "Background: E. coli and K. pneumoniae are common causes of both community- and hospital-acquired bloodstream infections (BSI). Resistance to commonly used antibiotics threatens the treatment of these infections. We describe the antibiotic resistance profiles and outcomes of CA- and HA-BSI with these organisms in a tertiary hospital in Cape Town, South Africa. Methods & Materials: Patients with E. coli (n = 70) and K. pneumoniae (n = 70) bacteraemia identified at Tygerberg Hospital between April 2015 and March 2016 were included. Admission and discharge dates, BC collection date, and outcome were obtained through record review. A 72-hour cut-off differentiated HA- and CA-infections. ESBL-genes were characterised by PCR and DNA sequencing; isolates were typed using REP-PCR and PFGE. Chi-square and Mann-Whitney tests were used to estimate the significance of correlation. Results: 45% of patients were male, and 31% were paediatric (<18 years); 66% of BSI were hospital-acquired. K. pneumoniae accounted for 61% of HA-isolates; 72% of CA-isolates were E. coli. 56% of K. pneumoniae and 16% of E. coli were cephalosporin resistant (presumed ESBL). Patients spent an average of 11 days (16,9 HA; 0,7 CA) in hospital before BC collection. HA-isolates were associated with cephalosporin resistance. Quinolone resistance was similar in both CA and HA E. coli (24% vs 25%); gentamicin resistance was more common in CA E. coli (21% vs 11%). The 30-day mortality rate was 30%, with no association between mortality and cephalosporin resistance or HA-infection. All isolates were carbapenemase gene negative. TEM and SHV were the commonest β-lactamases in E. coli (70%) and K. pneumoniae (84,3%) respectively. Multiple β-lactamase genes were present in 60% of K. pneumoniae isolates, and 5.7% of E. coli isolates. Strain typing showed substantial diversity among both organisms with minimal clustering, suggesting multiple clones in the hospital. Conclusion: The association between antibiotic resistance and hospital acquisition is not surprising. Resistance rates in CA-infections deserve further attention, and may reflect antibiotic usage patterns in the community. More detailed prospective studies are required to better understand the effect of resistance on outcomes. The diversity among both HA- and CA-isolates precluded any associations between strain type and resistance phenotype or genotype." @default.
- W2884676598 created "2018-08-03" @default.
- W2884676598 creator A5008016027 @default.
- W2884676598 creator A5068738780 @default.
- W2884676598 creator A5086584366 @default.
- W2884676598 date "2018-08-01" @default.
- W2884676598 modified "2023-09-26" @default.
- W2884676598 title "The epidemiology of Gram negative bacteraemia at Tygerberg Hospital" @default.
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- W2884676598 doi "https://doi.org/10.1016/j.ijid.2018.04.3693" @default.
- W2884676598 hasPublicationYear "2018" @default.