Ms Frances Sheehan1,2, Dr Meru Sheel1, Dr Kathryn Daveson2, Dr Karina Kennedy1,2
1Australian National University, Canberra, Australia
2The Canberra Hospital, Canberra, Australia
Method: Using data from ACT Pathology, we identified all episodes of ESBL E. coli blood stream infection from 2016 – 2020. The antibiotic sensitivities of each isolate were reviewed to identify those with a non-susceptibility to both ciprofloxacin and trimethoprim-sulfamethoxazole. We then matched these oral co-resistant isolates (cases) by sex and age with fully susceptible E. coli isolates (controls) to compare onset classification, source and 30-day outcome.
Results: A total of 79 oral co-resistant cases were identified and matched with two fully susceptible controls. There were more than three times as many cases (56%) than controls (16%) whose onset of infection was classified as healthcare associated. The source of infection for almost half the controls (46%) was urinary tract infection but a more mixed picture for cases.
Conclusion: Patients with an E. coli blood stream infection, who have had a recent acute health care interaction are more likely to have an isolate that is resistant to oral treatment options. Additional risk factors are being examined. Early identification of risk factors associated with resistant organisms will result in more targeted antimicrobial choice leading to better patient outcomes.
Background: A particular extended spectrum β-lactamase (ESBL) Escherichia coli (E. coli) phenotype, with non-susceptibility to ciprofloxacin and trimethoprim-sulfamethoxazole has been noted to be increasing locally. This ESBL with ‘oral co-resistance’ phenotype often leaves patients without oral options for treatment leading to increased health care utilisation, and potentially increases morbidity and mortality. We aimed to explore the risk factors associated with developing this particular phenotype.
Biography: Fran is a registered nurse with 15 years experience in a variety of health settings, specialising in public health and critical care nursing. She is currently completing her Master of Applied Epidemiology at the Department of Infectious Diseases, The Canberra Hospital. Fran is focussed on the use of data to inform decision making to drive better health outcomes and responsible resource allocation.