Ascertainment of ESBL-producing E. coli infections in 2002 and 2003 survey of English microbiology laboratories
Abstract number: 1134_01_392
Glasswell A.D., Pearson A.D., McKeown E.A., Livermore D.M., Lee-Duggal A.J.
Infections caused by Escherichia coli with extended-spectrum CTX-M beta-lactamases are a rapidly growing problem in the UK. A survey of English microbiology laboratories was carried out to audit the methodology used to detect ESBL-producing E. coli, to identify the extent of community-acquired urinary tract or bloodstream infections with ESBL producers, and to establish the extent of any public health investigation.
Questionnaires were sent to all clinical microbiology laboratories across England in January 2004. Analysis of the responses was undertaken.
A total of 142 laboratories returned completed questionnaires. A standard method for detecting ESBLs was used by 72% of the responders though the precise methods varied among sites (16% of responders did not know whether or not they used a standard method, or did not answer the question). ESBL-producing E. coli was detected from blood cultures in hospitalised patients by 44% of responders (27% did not know). Fourteen responders (10%) had detected ESBL-producing E. coli from blood cultures from community patients or samples (30% did not know). ESBL-producing E. coli had been detected in urine samples by 42% of responders from hospitalised patients (32% did not know) whilst 37% reported that they had detected producers in community patients or samples (35% did not know). Thirty-two responders (23%) reported that there had been a local investigation of multi-drug resistant infections caused by ESBL-producing E. coli (3% did not know) in the preceding 24 months.
The survey revealed numerous detections and several investigations into potential outbreaks of ESBL-producing E. coli across England during 2002 and 2003. These findings support the view, based on routine surveillance and reference submissions, that ESBL-producing E. coli are an emerging problem, also that they are occurring in community as well as hospitalised patients. Most laboratories had methods for ESBL detection, but standardised national guidance has recently been published by the Health Protection Agency (http://www.hpa.org.uk). A follow-up questionnaire is due to be sent out early in 2005.
|Session name:||XXIst ISTH Congress|
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