[Trend of detection of cefotaxime-resistant Escherichia coli and clinical features of bloodstream infection due to extended-spectrum β-lactamase producing Escherichia coli in a general hospital].

Recently, the community pandemic infections of cefotaxime (CTX)-M type extended-spectrum β-lactamase (ESBL) producing bacteria, which is mostly resistant to CTX, has been well-known as major problems. When the ESBL-confirmation test cannot be done, CTX-resistant Escherichia coli might be used as the alternation method of infectious control. We investigated tendency of third-generation cephalosporin resistant E. coli and the clinical features of bloodstream infections (BSI) due to ESBL producing E. coli in our hospital, which has no department of microbial examination. We examined the trend of detection of CTX-resistant E. coli isolates from clinical samples from January 2009 to November 2013, and antimicrobial use density (AUD) of third-generation cephalosporins in the same period, and the clinical features of BSI of ESBL-producing E. coli. As a result, the percentages of CTX-resistant E. coli in all E. coli were 5.4% in inpatient and 3.9% in outpatient in 2009, but 32.8% and 17.8% in 2013, respectively. Additionally, AUD had increased from 20.6 in 2009 to 28.9 in 2013. In BSI due to E. coli, the clinical features which were male, bedridden patient and using urethral catheter, central venous catheter, chronic renal failure were significantly in the cases of ESBL-producing E. coli (n=8), compared to non-ESBL producing E. coli (n=32).