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Retrospective analysis of a large single cohort of Enterobacteriaceae producing extended-spectrum B-lactamase (E-ESBL) patients: incidence, microbiology, and mortality

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Abstract

We conducted a retrospective study from 2005 to 2019 to describe the epidemiology and mortality of enterobacterial producing extended-spectrum β-lactamase (E-ESBL) infections in our university hospital over a 17-year period of time. Clinical and microbiological data were extracted from different software used for continuous surveillance. Stool samples from systematic screening for E-ESBL colonization were excluded from the study. The incidence rate of infected patient was calculated by E-ESBL species and by year. A comparison of mortality rate in patients with bloodstream infections versus other types of infections was conducted using a Kaplan–Meier method survival curves. A log rank test (with a risk of 5%) was carried out. A total of 3324 patients with E-ESBL infection were included with an increased incidence density per 1000 days of hospitalization from 0.03 in 2005 to 0.47 in 2019. Escherichia coli was the most frequently isolated pathogen (64%). Global mortality rate was significantly higher with E. coli than with Klebsiella spp. and Enterobacter spp. (p < 0.001). Mortality was higher in patients with E-ESBL bloodstream infection than in patients with other type of E-ESBL infection (p < 0.001). Our study showed a significant increase of the E-ESBL incidence density over a 17-year period survey with a higher mortality in patients with E-ESBL bacteremia. This highlights the need to continue efforts to control the spread of these multi-resistant bacteria in our institution.

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Data availability

The data analyzed were extracted from the laboratory database of our hospital and from the computerized patient records. The analysis was done in a transparent manner, and the database is available.

Code availability

Not applicable.

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Authors and Affiliations

  1. Hospital Hygiene Department, Nantes University Hospital, 5, rue du Prof. Yves Boquien, R44093, Nantes, France

    Camille Bouchand, Anaïs Andréo, Florence Le Gallou, Céline Bourigault & Didier Lepelletier

  2. Laboratory of Bacteriology, Nantes University Hospital, R44093, Nantes, France

    Stéphane Corvec

  3. IIcimed 1155 Laboratory, Institut de Recherche en Santé 2, Nantes Université, R44035, Nantes, France

    Didier Lepelletier

Authors
  1. Camille Bouchand
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  2. Anaïs Andréo
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  3. Florence Le Gallou
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  4. Stéphane Corvec
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  5. Céline Bourigault
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  6. Didier Lepelletier
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Camille Bouchand and Didier Lepelletier. The first draft of the manuscript was written by Camille Bouchand and Didier Lepelletier, and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Didier Lepelletier.

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Bouchand, C., Andréo, A., Le Gallou, F. et al. Retrospective analysis of a large single cohort of Enterobacteriaceae producing extended-spectrum B-lactamase (E-ESBL) patients: incidence, microbiology, and mortality. Eur J Clin Microbiol Infect Dis 41, 1237–1243 (2022). https://doi.org/10.1007/s10096-022-04489-2

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