Rise in the prevalence of resistance to extended-spectrum cephalosporins in the USA, nursing homes and antibiotic prescribing in outpatient and inpatient settings

被引:10
|
作者
Goldstein, Edward [1 ]
机构
[1] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Ctr Communicable Dis Dynam, Boston, MA 02115 USA
基金
英国惠康基金;
关键词
ESCHERICHIA-COLI; COMMUNITY HOSPITALS; INFECTIONS;
D O I
10.1093/jac/dkab251
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The prevalence of resistance to extended-spectrum (ES) cephalosporins for multiple types of infections treated in US hospitals and the incidence of hospitalization with ESBL-producing Enterobacteriaceae (many of which are detected in nursing home residents) have grown markedly in recent years. Here, I review these developments, as well as evidence for their adverse consequences, including the increase in the overall burden of bacterial infections due to proliferation of ESBL-producing/ES cephalosporin-resistant bacteria, the contribution of ESBL-producing/ES cephalosporin-resistant bacteria to the increase in the burden of mortality associated with bacterial infections and the contribution of the proliferation of ESBL-producing bacteria to the prevalence of carbapenem resistance. I argue that in order to mitigate the escalation of these phenomena, a reduction in outpatient prescribing of cephalosporins, especially to older adults, mitigation of transmission of ESBL-producing organisms in nursing homes and a reduction in inpatient prescribing of ES cephalosporins (which has seen a major increase in recent years) are needed.
引用
收藏
页码:2745 / 2747
页数:3
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