High burden of extended-spectrum β-lactamase-positive Escherichia coli in geriatric patients.
Few studies have described how an expanding elderly population influences the burden of antimicrobial resistance in micro-organisms. This study aimed to investigate trends in age-stratified extended-spectrum β-lactamase (ESBL)-positive Escherichia coli metrics in relation to an ageing population. The antimicrobial resistance database of E. coli from a healthcare region in Hong Kong from 2003 to 2012 was retrospectively reviewed. Future trends in age-stratified ESBL metrics were predicted up to 2022. Susceptibility results of clinical E. coli isolates from patients aged 0-74 years (n = 17 853) and aged ≥75 years (n = 17 047) were analysed. For the period 2003-2012, 23.7 % of the hospital admissions were of patients aged ≥75 years. However, approximately half of the annual ESBL-positive E. coli isolates were recovered from patients aged ≥75 years, being 55.0 % (233/424) in 2003 and 56.0 % (639/1142) in 2012. During this period of time, the annual prevalence and cumulative incidence of ESBL-positive E. coli in patients aged ≥75 years were significantly higher than in patients aged 0-74 years. From 2012-2022, it is predicted that ESBL-positive E. coli prevalence among patients aged 0-74 years and ≥75 years would increase from 25.4 % to 50.2 % and from 30.8 % to 70.0 %, respectively. In 2022, the predicted ESBL-positive E. coli cumulative incidence would be 63.7 per 10 000 admissions and 178.7 per 10 000 admissions among patients aged 0-74 years and ≥75 years, respectively. In conclusion, a rapidly expanding elderly population would substantially add to the burden of ESBL.
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Pak-Leung
PL
Ho
School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Pui-Hing
PH
Chau
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Mei-Kum
MK
Yan
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Kin-Hung
KH
Chow
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Jonathan H K
JHK
Chen
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Sally C Y
SCY
Wong
Department of Microbiology and Carol Yu Centre for Infection, University of Hong Kong, Hong Kong Special Administrative Region, PR China.
Vincent C C
VCC
Cheng
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D005260:Female; D015964:Gene Expression Regulation, Bacterial / Q000502:physiology; D015971:Gene Expression Regulation, Enzymologic; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
D001618:beta-Lactamases