Retrospective observational study of Escherichia.coli bacteraemia in West Midlands, England, 2012-2016
PHE ePoster Library. Suleman S. Sep 12, 2017; 186676; 191
Mr. Shakeel Suleman
Mr. Shakeel Suleman
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Abstract BackgroundSurveillance of Escherichia.coli (E.coli) bacteraemia has been mandatory in England since 2011 after laboratory reports showed a year-on-year increase as well as concerns about antimicrobial resistance. We undertook this study to understand the magnitude of the problem in the West Midlands and identify possible areas for intervention.MethodsDescriptive analysis of individual level data on all E.coli bacteraemia cases in the West Midlands reported to the English mandatory surveillance system from 2012 to 2016. We matched these records to antibiotic susceptibility data from the PHE Antimicrobial resistance surveillance system using a unique identifier. Findings Between 2012 and 2016, incidence increased by 20.9% (3436 vs. 4153 reports); the annual percentage change over the period was 4.2%. The majority of cases (71%) occurred in persons aged ≥65 and females (53 %). These proportions remained stable over the period.The most common primary foci of infection, which remained stable over the period, were the urinary tract (60.2%) and the hepatobiliary system (17.5.1%). In 2016, E.coli isolates were non-susceptible to ciprofloxacin (15.8%), 3rd generation cephalosporins (10.0%), gentamicin (7.6%), piperacillin/tazobactam 13.5% and carbapenems (0.08%). In 2016, antibiotic non-susceptibility was higher among cases categorised as “Trust” compared to “Non-Trust” cases.DiscussionThe incidence of E.coli bacteraemia continues to increase annually. West Midlands trends in antibiotic non-susceptibility were broadly consistent with England estimates and we found higher non-susceptibility among “Trust” cases in all antibiotic categories. This finding underscores the importance of antimicrobial stewardship activities in healthcare settings as well as interventions rooted in the health economy.
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