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Increasing incidence and antimicrobial resistance in Escherichia coli bloodstream infections: a multinational population-based cohort study

MacKinnon, Melissa C.; McEwen, Scott A.; Pearl, David L.; Lyytikäinen, O; Jacobsson, G.; Collignon, Peter; Gregson, Daniel; Valiquette, Louis; Laupland, Kevin B.

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Background: Escherichia coli is an important pathogen in humans and is the most common cause of bacterial bloodstream infections (BSIs). The objectives of our study were to determine factors associated with E. coli BSI incidence rate and third-generation cephalosporin resistance in a multinational population-based cohort. Methods: We included all incident E. coli BSIs (2014–2018) from national (Finland) and regional (Australia [Canberra], Sweden [Skaraborg], and Canada [Calgary, Sherbrooke, and...[Show more]

dc.contributor.authorMacKinnon, Melissa C.
dc.contributor.authorMcEwen, Scott A.
dc.contributor.authorPearl, David L.
dc.contributor.authorLyytikäinen, O
dc.contributor.authorJacobsson, G.
dc.contributor.authorCollignon, Peter
dc.contributor.authorGregson, Daniel
dc.contributor.authorValiquette, Louis
dc.contributor.authorLaupland, Kevin B.
dc.date.accessioned2022-11-11T05:19:38Z
dc.date.available2022-11-11T05:19:38Z
dc.identifier.issn2047-2994
dc.identifier.urihttp://hdl.handle.net/1885/278424
dc.description.abstractBackground: Escherichia coli is an important pathogen in humans and is the most common cause of bacterial bloodstream infections (BSIs). The objectives of our study were to determine factors associated with E. coli BSI incidence rate and third-generation cephalosporin resistance in a multinational population-based cohort. Methods: We included all incident E. coli BSIs (2014–2018) from national (Finland) and regional (Australia [Canberra], Sweden [Skaraborg], and Canada [Calgary, Sherbrooke, and western interior]) surveillance. Incidence rates were directly age and sex standardized to the European Union 28-country 2018 population. Multivariable negative binomial and logistic regression models estimated factors significantly associated with E. coli BSI incidence rate and third-generation cephalosporin resistance, respectively. The explanatory variables considered for inclusion in both models were year (2014–2018), region (six areas), age (< 70-years-old and ≥ 70-years-old), and sex (female and male). Results: We identified 31,889 E. coli BSIs from 40.7 million person-years of surveillance. Overall and third-generation cephalosporin-resistant standardized rates were 87.1 and 6.6 cases/100,000 person-years, respectively, and increased 14.0% and 40.1% over the five-year study. Overall, 7.8% (2483/31889) of E. coli BSIs were third-generation cephalosporin-resistant. Calgary, Canberra, Sherbrooke, and western interior had significantly lower E. coli BSI rates compared to Finland. The significant association between age and E. coli BSI rate varied with sex. Calgary, Canberra, and western interior had significantly greater odds of third-generation cephalosporin-resistant E. coli BSIs compared to Finland. Compared to 2014, the odds of third-generation cephalosporin-resistant E. coli BSIs were significantly increased in 2016, 2017, and 2018. The significant association between age and the odds of having a third-generation cephalosporin-resistant E. coli BSI varied with sex. Conclusions: Increases in overall and third-generation cephalosporin-resistant standardized E. coli BSI rates were clinically important. Overall, E. coli BSI incidence rates were 40–104% greater than previous investigations from the same study areas. Region, sex, and age are important variables when analyzing E. coli BSI rates and third-generation cephalosporin resistance in E. coli BSIs. Considering E. coli is the most common cause of BSIs, this increasing burden and evolving third-generation cephalosporin resistance will have an important impact on human health, especially in aging populations.
dc.description.sponsorshipMCM’s PhD program is supported by a Banting and Charles Best Canadian Graduate Scholarship Doctoral Award from the Canadian Institutes of Health Research, a Brock Doctoral Scholarship from the University of Guelph, an OVC Scholarship from the Ontario Veterinary College at the University of Guelph and funding from the Genome Research Development Initiative through the Government of Canada.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherBioMed Central Ltd.
dc.rights© The Author(s) 2021. Open Access
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceAntimicrobial Resistance and Infection Control
dc.subjectPopulation-based
dc.subjectBloodstream infection
dc.subjectBacteremia
dc.subjectEscherichia coli
dc.subjectIncidence rate
dc.subjectAntimicrobial resistance
dc.subjectThird-generation cephalosporins
dc.titleIncreasing incidence and antimicrobial resistance in Escherichia coli bloodstream infections: a multinational population-based cohort study
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume10
dc.date.issued2021
local.identifier.absfor320700 - Medical microbiology
local.identifier.ariespublicationa383154xPUB21963
local.publisher.urlhttps://aricjournal.biomedcentral.com/
local.type.statusPublished Version
local.contributor.affiliationMacKinnon, Melissa C., Department of Population Medicine, University of Guelph
local.contributor.affiliationMcEwen, Scott A. , University of Guelph
local.contributor.affiliationPearl, David L., Department of Population Medicine, University of Guelph
local.contributor.affiliationLyytikäinen, O, National Institute for Health and Welfare
local.contributor.affiliationJacobsson, G., Skaraborg Hospital
local.contributor.affiliationCollignon, Peter, College of Health and Medicine, ANU
local.contributor.affiliationGregson, Daniel, University of Calgary
local.contributor.affiliationValiquette, Louis, Universite de Sherbrooke
local.contributor.affiliationLaupland, Kevin B., Department of Medicine, Royal Inland Hospital
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage10
local.identifier.doi10.1186/s13756-021-00999-4
local.identifier.absseo200104 - Prevention of human diseases and conditions
dc.date.updated2021-11-28T07:27:21Z
local.identifier.scopusID2-s2.0-85114292811
dcterms.accessRightsOpen Access
dc.provenanceThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
dc.rights.licenseCreative Commons Attribution 4.0 International License
CollectionsANU Research Publications

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