Abstract
Escherichia coli ST131 has emerged as a global epidemic, multidrug-resistant clone of E. coli causing extra-intestinal infections. It is now highly prevalent among fluoroquinolone-resistant and CTX-M ESBL-producing E. coli isolates worldwide. Humans are likely the primary reservoir of ST131. Factors associated with its acquisition include residence in long-term care facilities and recent receipt of antimicrobial agents. E. coli ST131 causes a wide array of infections ranging from cystitis to life-threatening sepsis. Fluoroquinolones and trimethoprim-sulfamethoxazole are no longer adequate options for empiric therapy when E. coli ST131 is suspected from risk factors and local epidemiology. Expanded-spectrum cephalosporins, piperacillin- tazobactam and carbapenems are options to treat serious non-ESBL-producing E. coli ST131 infections, while carbapenems are indicated for ESBL-producing infections. There is a growing interest in reevaluating oral agents including fosfomycin and pivmecillinam for less serious infections such as uncomplicated cystitis.
Original language | English |
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Pages (from-to) | 597-609 |
Number of pages | 13 |
Journal | Expert Review of Anti-Infective Therapy |
Volume | 12 |
Issue number | 5 |
DOIs | |
Publication status | Published - 01-01-2014 |
Externally published | Yes |
All Science Journal Classification (ASJC) codes
- Microbiology
- Microbiology (medical)
- Infectious Diseases
- Virology