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Incidence of Extended-Spectrum Beta-Lactamase E.coli and Klebsiella pneumoniae Infections in the US: a Systematic Review

McDanel J, Schweizer ML, Crabb V, Nelson R, Samore M, Khader K, Blevins A, Diekema DJ, Perencevich EN. Incidence of Extended-Spectrum Beta-Lactamase E.coli and Klebsiella pneumoniae Infections in the US: a Systematic Review. Poster session presented at: Society for Healthcare Epidemiology of America Annual Scientific Meeting; 2015 May 15; Orlando, FL.




Abstract:

Objective: To perform a systematic literature review to identify the incidence of extended-spectrum beta-lactamase (ESBL) E.coli and Klebsiella pneumoniae (KPN) infections in the US. Methods: We searched PubMed, CINAHL, Cochrane, NHS Economic Evaluation Database, Web of Science and EMBASE for multicenter ( 8 sites), US studies published between 2000-2014 that evaluated ESBL-E.coli and ESBL-KPN infection incidence. We excluded studies that examined resistance rates or did not provide a denominator. Results: Of 47,043 studies assessed, 5 met the inclusion criteria (Table). Incidence differed by patient population, time, and ESBL definition. The incidence ranged from 0 infections per 100,000 patient-days to 16.64 infections per 10,000 discharges and increased over time. Rates were slightly higher for ESBL-KPN infections. Conclusion: The incidence of ESBL-E.coli and ESBL-KPN infections in the US has increased since 2000 with slightly higher ESBL-KPN rates. No studies meeting our inclusion criteria were published since 2009. Multicenter surveillance studies targeting ESBL are needed.





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