Carbapenem-resistant Escherichia coli

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Carbapenem-resistant Escherichia coli
Other names: CREC
  • Top:Global distribution of CREC(and the proportion of different CRGs in countries where strains >100 have been reported)[1]

  • Bottom: Carbapenem-Resistant Escherichia coli from China, 2015 to 2017 -"Genetic relatedness and phylogenetic analysis showed that isolates with the same ST had high degree of homology"...image depicts SNP phylogenies of carbapenem-resistant E.coli isolates[2]
SpecialtyInfectious disease
SymptomsFever, shortness of breath[3]
ComplicationsMeningitis, urinary tract infections, intra-abdominal infections and bloodstream infections[4][1]
Diagnostic methodMolecular tests[5]
TreatmentCeftolozane and tazobactam[6]

Carbapenem-resistant Escherichia coli (CREC) is a type of bacteria that has developed resistance to carbapenem antibiotics.[7]CREC primarily gains resistance through plasmid-encoded carbapenemases, which spread among bacteria; and can cause various infections, including bloodstream infections.[8][9]

In terms of management we find that due to their resistance to most antibiotics, therefore treatment decisions are on a case by case basis[7]

The prevalence of CREC varies across different regions, a 2022 study found that carbapenemase-producing Escherichia coli was present in 36 countries[10]

Signs and symptoms

The presentation of Carbapenem-resistant Escherichia coli are consistent with the following:[needs copy edit]

Complications

The complications of CREC are as follows:[1][1][4]

Risk factors

The following are risk factors in the acquisition of Carbapenem-resistant Escherichia coli:[11][12][2]

Mechanism

Mechanisms of carbapenem resistance in Enterobacteriaceae[13]

In terms of the mechanism of Carbapenem-resistant Escherichia coli we find that resistance is developed via several key aspects:[12][14]

  • Carbapenemase production

Diagnosis

In order to ascertain if an individual has Carbapenem-resistant Escherichia coli the following is done:[5][clarification needed]

  • Medical exam(symptoms presented)
  • Sample collection(and subsequent test)
  • Blood
  • Urine

Treatment

In terms of treatment of Carbapenem-resistant Escherichia coli the combination of ceftolozane and tazobactam has been licensed for use against E. coli per 2018 review. However it has a "weaker effect against multiresistant strains ESBL (E. coli[15]).[6]

Epidemiology

In terms of the epidemiology of Carbapenem-resistant Escherichia coli is more prevalent in developed countries that developing countries, and spread occurs in contaminated healthcare settings. A 2023 study, indicated that 30% of long-term hospitalized individuals in Chicago (U.S.) were CREC carriers, and 3.3% of individuals in ICU were carriers[16]

See also

Notes

1.^ Due to lack of Carbapenem-resistant Escherichia coli specific reviews some primary sources are used.

References

  1. ↑ 1.0 1.1 1.2 Huang, Jiewen; Lv, Chao; Li, Min; Rahman, Tanvir; Chang, Yung-Fu; Guo, Xiaokui; Song, Zhen; Zhao, Yanan; Li, Qingtian; Ni, Peihua; Zhu, Yongzhang (6 January 2024). "Carbapenem-resistant Escherichia coli exhibit diverse spatiotemporal epidemiological characteristics across the globe". Communications Biology. 7 (1): 1–13. doi:10.1038/s42003-023-05745-7. ISSN 2399-3642. Retrieved 9 October 2024. CREC can lead to severe infections, including intra-abdominal infections, pneumonia, urinary tract infections, and device-associated infections.
  2. ↑ Li, Fengtian; Ye, Kun; Li, Xin; Ye, Liyan; Guo, Ling; Wang, Lifeng; Yang, Jiyong (17 September 2021). "Genetic characterization of Carbapenem-Resistant Escherichia coli from China, 2015-2017". BMC microbiology. 21 (1): 248. doi:10.1186/s12866-021-02307-x. ISSN 1471-2180. Archived from the original on 8 October 2024. Retrieved 23 September 2024.
  3. ↑ "Escherichia coli (E coli) Infections Clinical Presentation: History, Physical, Causes". emedicine.medscape.com. Archived from the original on 8 October 2024. Retrieved 2 October 2024.
  4. ↑ 4.0 4.1 "Increase in cases of carbapenem-resistant E. coli carrying the blaNDM-5 gene, EU/EEA countries". www.ecdc.europa.eu. 11 May 2023. Retrieved 9 October 2024.
  5. ↑ 5.0 5.1 "Guidance on Diagnosis & Management of Carbapenem Resistant Gram-negative infections" (PDF). main.icmr.nic.in. Archived (PDF) from the original on 11 August 2024. Retrieved 2 October 2024.
  6. ↑ 6.0 6.1 Fritzenwanker, Moritz; Imirzalioglu, Can; Herold, Susanne; M. Wagenlehner, Florian; Zimmer, Klaus-Peter; Chakraborty, Trinad (May 2018). "Treatment Options for Carbapenem-Resistant Gram-Negative Infections". Deutsches Ärzteblatt International. 115 (20–21): 345–352. doi:10.3238/arztebl.2018.0345. ISSN 1866-0452. Retrieved 8 October 2024.
  7. ↑ 7.0 7.1 "About Carbapenem-resistant Enterobacterales". Enterobacterales (carbapenem-resistance). 14 May 2024. Archived from the original on 10 August 2024. Retrieved 20 September 2024.
  8. ↑ Kong, Haifang; Hu, Zhidong; Zhang, Longtao; Chen, Qianqian; Yang, Ling; Li, Jin; Tian, Bin; Chai, Yamin; Feng, Xuequan (2 July 2024). "Clinical risk factors and outcomes of carbapenem-resistant Escherichia coli nosocomial infections in a Chinese teaching hospital: a retrospective study from 2013 to 2020". Microbiology Spectrum. 12 (7). doi:10.1128/spectrum.04228-23. ISSN 2165-0497. Archived from the original on 23 September 2024. Retrieved 20 September 2024.
  9. ↑ Cole, Stephen D.; Peak, Laura; Tyson, Gregory H.; Reimschuessel, Renate; Ceric, Olgica; Rankin, Shelley C. (February 2020). "New Delhi Metallo-β-Lactamase-5–Producing Escherichia coli in Companion Animals, United States". Emerging Infectious Diseases. 26 (2): 381–383. doi:10.3201/eid2602.191221. Archived from the original on 2024-09-25. Retrieved 2024-09-20.
  10. ↑ Peirano, Gisele; Chen, Liang; Nobrega, Diego; Finn, Thomas J.; Kreiswirth, Barry N.; DeVinney, Rebekah; Pitout, Johann D.D. (May 2022). "Genomic Epidemiology of Global Carbapenemase-Producing Escherichia coli, 2015–2017". Emerging Infectious Diseases. 28 (5). doi:10.3201/eid2805.212535. Archived from the original on 2024-09-19. Retrieved 2024-09-20.
  11. ↑ Lian, Siyan; Liu, Chang; Cai, Meili; Cao, Yingping; Xu, Xiaohong (28 September 2024). "Risk factors and molecular characterization of carbapenem resistant Escherichia coli recovered from a tertiary hospital in Fujian, China from 2021 to 2023". BMC Microbiology. 24 (1): 374. doi:10.1186/s12866-024-03525-9. ISSN 1471-2180.
  12. ↑ 12.0 12.1 Jeon, Min-Hyok; Choi, Sang-Ho; Kwak, Yee Gyung; Chung, Jin-Won; Lee, Sang-Oh; Jeong, Jin-Yong; Woo, Jun Hee; Kim, Yang Soo (1 December 2008). "Risk factors for the acquisition of carbapenem-resistant Escherichia coli among hospitalized patients". Diagnostic Microbiology and Infectious Disease. 62 (4): 402–406. doi:10.1016/j.diagmicrobio.2008.08.014. ISSN 0732-8893. Archived from the original on 15 April 2024. Retrieved 20 September 2024.
  13. ↑ Dixon, Breanna; Ahmed, Waqar M; Felton, Tim; Fowler, Stephen J (1 November 2022). "Molecular phenotyping approaches for the detection and monitoring of carbapenem-resistant Enterobacteriaceae by mass spectrometry". Journal of Mass Spectrometry and Advances in the Clinical Lab. 26: 9–19. doi:10.1016/j.jmsacl.2022.09.001. ISSN 2667-145X.
  14. ↑ Tian, Xuebin; Zheng, Xiangkuo; Sun, Yao; Fang, Renchi; Zhang, Siqin; Zhang, Xiucai; Lin, Jie; Cao, Jianming; Zhou, Tieli (17 February 2020). "Molecular Mechanisms and Epidemiology of Carbapenem-Resistant Escherichiacoli Isolated from Chinese Patients During 2002–2017". Infection and Drug Resistance. 13: 501–512. doi:10.2147/IDR.S232010. ISSN 1178-6973. Retrieved 12 October 2024.
  15. ↑ "About ESBL-producing Enterobacterales". ESBL-producing Enterobacterales. 16 May 2024. Retrieved 8 October 2024.
  16. ↑ Ding, Ying; Zhuang, Hemu; Zhou, Junxin; Xu, Lijie; Yang, Yi; He, Jintao; Liang, Min; Jia, Shicheng; Guo, Xiuliu; Han, Xinhong; Liu, Haiyang; Zhang, Linghong; Jiang, Yan; Yu, Yunsong. "Epidemiology and Genetic Characteristics of Carbapenem-Resistant Escherichia coli in Chinese Intensive Care Unit Analyzed by Whole-Genome Sequencing: a Prospective Observational Study". Microbiology Spectrum. 11 (2): e04010–22. doi:10.1128/spectrum.04010-22. ISSN 2165-0497. Retrieved 10 October 2024.

Further reading

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