The rate of infections caused by extended-spectrum beta-lactamase-producing (ESBL)-Escherichia coli (E. coli) that is highly resistant to antibiotics has more than doubled in community hospitals, according to a study published online October 13 in Infection Control & Hospital Epidemiology. 

Joshua Thaden, MD, PhD, and colleagues studied 26 community hospitals in the southeastern United States, finding that the incidence of ESBL-E. coli infections increased from 5.28 to 10.5 per 100,000 patients from 2009 to 2014. During that period, the number of community hospitals that reported ESBL-E. coli infections increased from 17 (65%) to 20 (77%). The researchers found that approximately three-quarters of the infections were picked up after exposure at a hospital or encounters with the health care system, as opposed to community-associated infections. However, the group did note an increase in community-associated infections of ESBL-E. coli. In comparison, the researchers found that the incidence of infections caused by ESBL-producing Klebsiella pneumonia remained constant. 

Dr. Thaden noted that a lack of active screening for ESBL-producing bacteria in most hospitals results in inadequate infection prevention measures, such as contact isolation and patient cohorting, adding that “silently” colonized patients increase the risk of transmission to vulnerable patients via health care workers or environmental contamination.

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