Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme

Abernethy, Julia, Guy, Rebecca, Sheridan, Elizabeth, Hopkins, Susan, Kiernan, Martin, Wilcox, Mark, Johnson, Alan and Hope, Russell (2016) Epidemiology of Escherichia coli bacteraemia in England: results of an enhanced sentinel surveillance programme. Journal of Hospital Infection, 95 (4). pp. 365-375. ISSN 0195-6701

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Abstract

Background: Escherichia coli causes over one third of the bacteraemia cases in England each year, and the incidence of these infections is increasing.

Aim: To determine the underlying risk factors associated with E. coli bacteraemia.

Methods: A three month enhanced sentinel surveillance study involving 35 National Health Service hospitals was undertaken in the winter of 2012/13 to collect risk factor information and further details on the underlying source of infection to augment data already collected by the English national surveillance programme. Antimicrobial susceptibility results for E. coli isolated from blood
and urine were also collected.

Findings: A total of 1,731 cases of E. coli bacteraemia were included. The urogenital tract was the most commonly reported source of infection (51.2% of cases) with prior treatment for a urinary tract infection being the largest independent effect associated with this infection source. Half of all patients had prior healthcare exposure in the month prior to the bacteraemia with antimicrobial therapy and urinary catheterisation being reported in one third and one fifth of these patients. Prior healthcare exposure was associated with a higher proportion of antibiotic non-susceptibility in the blood culture isolates (P=0.001).

Conclusion: Analysis of risk factors suggests potential community and hospital-related interventions particularly better use of urinary catheters and improved antibiotic management of urinary tract infections. As part of the latter strategy, antibiotic resistance profiles need to be closely monitored to ensure treatment guidelines are up to date to limit inappropriate empiric therapy.

Item Type: Article
Additional Information: © 2016 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Uncontrolled Keywords: Urinary Tract Infection, Risk Factors, Healthcare Associated, Community
Subjects: Medicine and health > Health promotion and public health > Infection prevention
Medicine and health > Microbiology
Medicine and health > Clinical medicine > Clinical care
Medicine and health > Physiology
Depositing User: Martin Kiernan
Date Deposited: 04 Jan 2017 11:14
Last Modified: 03 Apr 2017 08:17
URI: http://repository.uwl.ac.uk/id/eprint/3018

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