Genetic characteristics and risk factors of extended-spectrum β-lactamase-producing Escherichia coli in Chinese intensive care unit: a prospective molecular epidemiology study

Abstract

The increasing prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) has made drug-resistant bacterial infections rise, endangering people’s health and causing socioeconomic burdens. We conducted an ESBL-EC screening program for patients and ward environments in an intensive care unit (ICU). The aim was to describe the molecular characteristics of ESBL-EC and the risk factors for ESBL-EC colonization. In our hospital, the colonization rate of ESBL-EC remained high. The dominant sequence type was ST10, which might be considered a strain of notable concern, possibly causing future outbreaks. However, ST131 and ST1193 should also be considered because they were associated with the majority of the ESBL-EC isolates found. Notably, CTX-M-14 gene screening should be considered in medication guidance because it is the main ESBL enzyme. Owing to the high transmission rate of ESBL-EC, effective interventions and active screening are critical for preventing and controlling its spread, guiding clinicians in rational antibiotic use.