Molecular epidemiology and clinical features of extended-spectrum beta-lactamase- or carbapenemase-producing Escherichia coli bacteremia in Japan.

• 資料種別: 博士論文
• タイトル: Molecular epidemiology and clinical features of extended-spectrum beta-lactamase- or carbapenemase-producing Escherichia coli bacteremia in Japan.
• 著者・編者: Komatsu, Yuko; Kasahara, Kei; Inoue, Takashi; Lee, Sang-Tae; Tamamoto, Tetsuro; Yano, Hisakazu; Kirita, Tadaaki; Mikasa, Keiichi
• 著者標目: Komatsu, Yuko; Kasahara, Kei; Inoue, Takashi; Lee, Sang-Tae; Tamamoto, Tetsuro; Yano, Hisakazu; Kirita, Tadaaki; Mikasa, Keiichi
• 出版事項: Public Library of Science
• 出版年月日等: 2018-08-29
• 出版年（W3CDTF）: 2018-08-29
• 並列タイトル等: 日本における基質拡張型β -ラクタマーゼまたはカルバペネマーゼ産生大腸菌菌血症の分子疫学と臨床的特徴
• タイトル（掲載誌）: PloS one
• 巻号年月日等（掲載誌）: 13 8
• 掲載巻: 13
• 掲載号: 8
• 掲載ページ: e0202276-
• ISSN（掲載誌）: ISSN : 1932-6203
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2018-11-30
• 報告番号: 甲第692号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 対象利用者: 一般
• 一般注記: type:Article; OBJECTIVES: To identify risk factors and clinical outcomes in patients with bacteremia due to extended-spectrum beta-lactamase (ESBL) or carbapenemase-producing Escherichia coli, as well as to determine the prevalence and genetic background of such isolates. METHODS: Case control study was performed with patients with E. coli bacteremia between January 2008 and May 2013 (n = 115) at a tertiary university hospital in Japan. Cases had ESBL-producing E. coli (ESBL-EC) whereas controls had non-ESBL-producing E. coli (non-ESBL-EC) isolates. A retrospective chart review was performed to identify risk factors and clinical outcomes. Isolates were characterized by antimicrobial susceptibility testing, polymerase chain reaction analysis for beta-lactamase genes, and multi-locus sequence typing. RESULTS: Of 115 unique cases of E. coli bacteremia, 30 (26.1%) were due to ESBL-EC and three (2.6%) were due to carbapenemase-producing E. coli. All three carbapenemase-producing E. coli isolates were IMP-6 and concurrently produced ESBL (ESBL/IMP-6-EC). ESBL-EC isolates showed multidrug resistance. Of the ESBL-EC isolates, CTX-M-27 was the most prevalent (33.3%), followed by CTX-M-14 (30%). Multi-locus sequence typing revealed that 19 (63.3%) isolates were ST131. The multivariate analysis identified nursing home-associated infections and antibiotic administration in the preceding 30 days as risk factors for ESBL-EC bacteremia. The 14-day mortality non-ESBL-EC, ESBL-EC, and ESBL/IMP-6-EC was 4.7% (4/85), 20% (6/30), and 66.7% (2/3), respectively. CONCLUSIONS: CTX-M-27, CTX-M-14, and ST131 were the most prevalent ESBL-EC isolates from bacteremic patients in a Japanese hospital. Further studies with larger sample sizes are warranted to investigate the clinical significance of ESBL-EC and ESBL/IMP-6-EC.; 博士（医学）・甲第692号・平成30年11月30日; Copyright: © 2018 Komatsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License(http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.; identifier:PloS one Vol.13 No.8 Article No.e0202276 (2018 Aug); identifier:19326203; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3503; identifier:PloS one, 13(8): e0202276
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1371/journal.pone.0202276
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3503/1/01%e7%94%b2692%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3503/2/02%e7%94%b2692%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3503/3/03%e7%94%b2692%e6%9c%ac%e6%96%87.pdf fulltext