Antibiotic Resistance and the Risk of Recurrent Bacteremia

Sjoukje H. S. Woudt; Sabine C. de Greeff; Annelot F. Schoffelen; Anne L. M. Vlek; Marc J. M. Bonten; J. W. T. Cohen Stuart; A. J. L. Weersink; C. M. J. E. Vandenbroucke-Grauls; C. E. Visser; M. L. van Ogtrop; D. J. Kaersenhout; M. Scholing; B. C. van Hees; P. H. J. van Keulen; J. A. J. W. Kluytmans; E. M. Kraan; E. E. Mattsson; F. W. Sebens; E. de Jong; H. M. E. Frénay; B. Maraha; A. J. van Griethuysen; W. Silvis; A. Demeulemeester; B. B. Wintermans; M. van Trijp; A. Ott; J. P. Arends; G. A. Kampinga; D. Veenendaal; C. Hol; E. I. G. B. de Brauwer; F. S. Stals; L. J. Bakker; J. W. Dorigo-Zetsma; B. Ridwan; J. H. van Zeijl; A. T. Bernards; S. Erkens-Hulshof; B. M. de Jongh; B. J. M. Vlaminckx; M. H. Nabuurs-Franssen; S. Kuipers; B. M. W. Diederen; D. C. Melles; M. van Rijn; S. Dinant; O. Pontesilli; P. de Man; N. Vaessen; M. A. Leversteijn-van Hall; E. P. M. van Elzakker; A. E. Muller; N. H. Renders; D. W. van Dam; A. G. M. Buiting; A. L. M. Vlek; M. P. D. Deege; F. N. J. Frakking; I. T. M. A. Overdevest; R. W. Bosboom; T. Trienekens; G. P. Voorn; G. J. H. M. Ruijs; M. J. H. M. Wolfhagen; J. Alblas; W. Altorf-van der Kuil; L. Blijboom; S. Groenendijk; J. van Heereveld; R. Hertroys; J. C. Monen; D. W. Notermans; E. A. Reuland; M. I. van Triest; C. C. H. Wielders

doi:https://doi.org/10.1093/cid/cix1076

Antibiotic Resistance and the Risk of Recurrent Bacteremia

Sjoukje H. S. Woudt, Sabine C. de Greeff, Annelot F. Schoffelen, Anne L. M. Vlek, Marc J. M. Bonten, J. W. T. Cohen Stuart, A. J. L. Weersink, C. M. J. E. Vandenbroucke-Grauls, C. E. Visser, M. L. van Ogtrop, D. J. Kaersenhout, M. Scholing, B. C. van Hees, P. H. J. van Keulen, J. A. J. W. Kluytmans, E. M. Kraan, E. E. Mattsson, F. W. Sebens, E. de Jong, H. M. E. FrénayB. Maraha, A. J. van Griethuysen, W. Silvis, A. Demeulemeester, B. B. Wintermans, M. van Trijp, A. Ott, J. P. Arends, G. A. Kampinga, D. Veenendaal, C. Hol, E. I. G. B. de Brauwer, F. S. Stals, L. J. Bakker, J. W. Dorigo-Zetsma, B. Ridwan, J. H. van Zeijl, A. T. Bernards, S. Erkens-Hulshof, B. M. de Jongh, B. J. M. Vlaminckx, M. H. Nabuurs-Franssen, S. Kuipers, B. M. W. Diederen, D. C. Melles, M. van Rijn, S. Dinant, O. Pontesilli, P. de Man, N. Vaessen, M. A. Leversteijn-van Hall, E. P. M. van Elzakker, A. E. Muller, N. H. Renders, D. W. van Dam, A. G. M. Buiting, A. L. M. Vlek, M. P. D. Deege, F. N. J. Frakking, I. T. M. A. Overdevest, R. W. Bosboom, T. Trienekens, G. P. Voorn, G. J. H. M. Ruijs, M. J. H. M. Wolfhagen, J. Alblas, W. Altorf-van der Kuil, L. Blijboom, S. Groenendijk, J. van Heereveld, R. Hertroys, J. C. Monen, D. W. Notermans, E. A. Reuland, M. I. van Triest, C. C. H. Wielders

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Abstract

Background Direct health effects of antibiotic resistance are difficult to assess. We quantified the risk of recurrent bacteremia associated with resistance. Methods We extracted antimicrobial susceptibility testing data on blood isolates from the Dutch surveillance system for antimicrobial resistance between 2008 and 2017. First and first recurrent (4-30 days) bacteremia episodes were categorized as susceptible, single nonsusceptible, or co-nonsusceptible to third-generation cephalosporins without or with carbapenems (Enterobacteriaceae), ceftazidime without or with carbapenems (Pseudomonas species), aminopenicillins without or with vancomycin (Enterococcus species), or as methicillin-sensitive/-resistant S. aureus (MSSA/MRSA). We calculated risks of recurrent bacteremia after nonsusceptible vs susceptible first bacteremia, estimated the crude population attributable effect of resistance for the Netherlands, and calculated risks of nonsusceptible recurrent bacteremia after a susceptible first episode. Results Risk ratios for recurrent bacteremia after a single- and co-nonsusceptible first episode, respectively, vs susceptible first episode, were 1.7 (95% confidence interval [CI], 1.5-2.0) and 5.2 (95% CI, 2.1-12.4) for Enterobacteriaceae, 1.3 (95% CI, 0.5-3.1) and 5.0 (95% CI, 2.9-8.5) for Pseudomonas species, 1.4 (95% CI, 1.2-1.7) and 1.6 (95% CI, 0.6-4.2) for Enterococcus species, and 1.6 (95% CI, 1.1-2.4) for MRSA vs MSSA. The estimated population annual number of recurrent bacteremias associated with nonsusceptibility was 40. The risk of nonsusceptible recurrent bacteremia after a susceptible first episode was at most 0.4% (Pseudomonas species). Conclusions Although antibiotic nonsusceptibility was consistently associated with higher risks of recurrent bacteremia, the estimated annual number of additional recurrent episodes in the Netherlands (40) was rather limited.

Original language	English
Pages (from-to)	1651-1657
Journal	Clinical Infectious Diseases
Volume	66
Issue number	11
DOIs	https://doi.org/10.1093/cid/cix1076
Publication status	Published - 2018

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Woudt, S. H. S., de Greeff, S. C., Schoffelen, A. F., Vlek, A. L. M., Bonten, M. J. M., Cohen Stuart, J. W. T., Weersink, A. J. L., Vandenbroucke-Grauls, C. M. J. E., Visser, C. E., van Ogtrop, M. L., Kaersenhout, D. J., Scholing, M., van Hees, B. C., van Keulen, P. H. J., Kluytmans, J. A. J. W., Kraan, E. M., Mattsson, E. E., Sebens, F. W., de Jong, E., ... Wielders, C. C. H. (2018). Antibiotic Resistance and the Risk of Recurrent Bacteremia. Clinical Infectious Diseases, 66(11), 1651-1657. https://doi.org/10.1093/cid/cix1076

@article{1a5122ff86414fc097b48861ee1837ca,

title = "Antibiotic Resistance and the Risk of Recurrent Bacteremia",

abstract = "Background Direct health effects of antibiotic resistance are difficult to assess. We quantified the risk of recurrent bacteremia associated with resistance. Methods We extracted antimicrobial susceptibility testing data on blood isolates from the Dutch surveillance system for antimicrobial resistance between 2008 and 2017. First and first recurrent (4-30 days) bacteremia episodes were categorized as susceptible, single nonsusceptible, or co-nonsusceptible to third-generation cephalosporins without or with carbapenems (Enterobacteriaceae), ceftazidime without or with carbapenems (Pseudomonas species), aminopenicillins without or with vancomycin (Enterococcus species), or as methicillin-sensitive/-resistant S. aureus (MSSA/MRSA). We calculated risks of recurrent bacteremia after nonsusceptible vs susceptible first bacteremia, estimated the crude population attributable effect of resistance for the Netherlands, and calculated risks of nonsusceptible recurrent bacteremia after a susceptible first episode. Results Risk ratios for recurrent bacteremia after a single- and co-nonsusceptible first episode, respectively, vs susceptible first episode, were 1.7 (95% confidence interval [CI], 1.5-2.0) and 5.2 (95% CI, 2.1-12.4) for Enterobacteriaceae, 1.3 (95% CI, 0.5-3.1) and 5.0 (95% CI, 2.9-8.5) for Pseudomonas species, 1.4 (95% CI, 1.2-1.7) and 1.6 (95% CI, 0.6-4.2) for Enterococcus species, and 1.6 (95% CI, 1.1-2.4) for MRSA vs MSSA. The estimated population annual number of recurrent bacteremias associated with nonsusceptibility was 40. The risk of nonsusceptible recurrent bacteremia after a susceptible first episode was at most 0.4% (Pseudomonas species). Conclusions Although antibiotic nonsusceptibility was consistently associated with higher risks of recurrent bacteremia, the estimated annual number of additional recurrent episodes in the Netherlands (40) was rather limited.",

author = "Woudt, {Sjoukje H. S.} and {de Greeff}, {Sabine C.} and Schoffelen, {Annelot F.} and Vlek, {Anne L. M.} and Bonten, {Marc J. M.} and {Cohen Stuart}, {J. W. T.} and Weersink, {A. J. L.} and Vandenbroucke-Grauls, {C. M. J. E.} and Visser, {C. E.} and {van Ogtrop}, {M. L.} and Kaersenhout, {D. J.} and M. Scholing and {van Hees}, {B. C.} and {van Keulen}, {P. H. J.} and Kluytmans, {J. A. J. W.} and Kraan, {E. M.} and Mattsson, {E. E.} and Sebens, {F. W.} and {de Jong}, E. and Fr{\'e}nay, {H. M. E.} and B. Maraha and {van Griethuysen}, {A. J.} and W. Silvis and A. Demeulemeester and Wintermans, {B. B.} and {van Trijp}, M. and A. Ott and Arends, {J. P.} and Kampinga, {G. A.} and D. Veenendaal and C. Hol and {de Brauwer}, {E. I. G. B.} and Stals, {F. S.} and Bakker, {L. J.} and Dorigo-Zetsma, {J. W.} and B. Ridwan and {van Zeijl}, {J. H.} and Bernards, {A. T.} and S. Erkens-Hulshof and {de Jongh}, {B. M.} and Vlaminckx, {B. J. M.} and Nabuurs-Franssen, {M. H.} and S. Kuipers and Diederen, {B. M. W.} and Melles, {D. C.} and {van Rijn}, M. and S. Dinant and O. Pontesilli and {de Man}, P. and N. Vaessen and {Leversteijn-van Hall}, {M. A.} and {van Elzakker}, {E. P. M.} and Muller, {A. E.} and Renders, {N. H.} and {van Dam}, {D. W.} and Buiting, {A. G. M.} and Vlek, {A. L. M.} and Deege, {M. P. D.} and Frakking, {F. N. J.} and Overdevest, {I. T. M. A.} and Bosboom, {R. W.} and T. Trienekens and Voorn, {G. P.} and Ruijs, {G. J. H. M.} and Wolfhagen, {M. J. H. M.} and J. Alblas and {Altorf-van der Kuil}, W. and L. Blijboom and S. Groenendijk and {van Heereveld}, J. and R. Hertroys and Monen, {J. C.} and Notermans, {D. W.} and Reuland, {E. A.} and {van Triest}, {M. I.} and Wielders, {C. C. H.}",

year = "2018",

doi = "https://doi.org/10.1093/cid/cix1076",

language = "English",

volume = "66",

pages = "1651--1657",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "11",

}

Woudt, SHS, de Greeff, SC, Schoffelen, AF, Vlek, ALM, Bonten, MJM, Cohen Stuart, JWT, Weersink, AJL, Vandenbroucke-Grauls, CMJE , Visser, CE, van Ogtrop, ML, Kaersenhout, DJ, Scholing, M, van Hees, BC, van Keulen, PHJ, Kluytmans, JAJW, Kraan, EM, Mattsson, EE, Sebens, FW, de Jong, E, Frénay, HME, Maraha, B, van Griethuysen, AJ, Silvis, W, Demeulemeester, A, Wintermans, BB, van Trijp, M, Ott, A, Arends, JP, Kampinga, GA, Veenendaal, D, Hol, C, de Brauwer, EIGB, Stals, FS, Bakker, LJ, Dorigo-Zetsma, JW, Ridwan, B, van Zeijl, JH, Bernards, AT, Erkens-Hulshof, S, de Jongh, BM, Vlaminckx, BJM, Nabuurs-Franssen, MH, Kuipers, S, Diederen, BMW, Melles, DC, van Rijn, M, Dinant, S, Pontesilli, O, de Man, P, Vaessen, N, Leversteijn-van Hall, MA, van Elzakker, EPM, Muller, AE, Renders, NH, van Dam, DW, Buiting, AGM, Vlek, ALM, Deege, MPD, Frakking, FNJ, Overdevest, ITMA, Bosboom, RW, Trienekens, T, Voorn, GP, Ruijs, GJHM, Wolfhagen, MJHM, Alblas, J, Altorf-van der Kuil, W, Blijboom, L, Groenendijk, S, van Heereveld, J, Hertroys, R, Monen, JC, Notermans, DW, Reuland, EA, van Triest, MI & Wielders, CCH 2018, 'Antibiotic Resistance and the Risk of Recurrent Bacteremia', Clinical Infectious Diseases, vol. 66, no. 11, pp. 1651-1657. https://doi.org/10.1093/cid/cix1076

TY - JOUR

T1 - Antibiotic Resistance and the Risk of Recurrent Bacteremia

AU - Woudt, Sjoukje H. S.

AU - de Greeff, Sabine C.

AU - Schoffelen, Annelot F.

AU - Vlek, Anne L. M.

AU - Bonten, Marc J. M.

AU - Cohen Stuart, J. W. T.

AU - Weersink, A. J. L.

AU - Vandenbroucke-Grauls, C. M. J. E.

AU - Visser, C. E.

AU - van Ogtrop, M. L.

AU - Kaersenhout, D. J.

AU - Scholing, M.

AU - van Hees, B. C.

AU - van Keulen, P. H. J.

AU - Kluytmans, J. A. J. W.

AU - Kraan, E. M.

AU - Mattsson, E. E.

AU - Sebens, F. W.

AU - de Jong, E.

AU - Frénay, H. M. E.

AU - Maraha, B.

AU - van Griethuysen, A. J.

AU - Silvis, W.

AU - Demeulemeester, A.

AU - Wintermans, B. B.

AU - van Trijp, M.

AU - Ott, A.

AU - Arends, J. P.

AU - Kampinga, G. A.

AU - Veenendaal, D.

AU - Hol, C.

AU - de Brauwer, E. I. G. B.

AU - Stals, F. S.

AU - Bakker, L. J.

AU - Dorigo-Zetsma, J. W.

AU - Ridwan, B.

AU - van Zeijl, J. H.

AU - Bernards, A. T.

AU - Erkens-Hulshof, S.

AU - de Jongh, B. M.

AU - Vlaminckx, B. J. M.

AU - Nabuurs-Franssen, M. H.

AU - Kuipers, S.

AU - Diederen, B. M. W.

AU - Melles, D. C.

AU - van Rijn, M.

AU - Dinant, S.

AU - Pontesilli, O.

AU - de Man, P.

AU - Vaessen, N.

AU - Leversteijn-van Hall, M. A.

AU - van Elzakker, E. P. M.

AU - Muller, A. E.

AU - Renders, N. H.

AU - van Dam, D. W.

AU - Buiting, A. G. M.

AU - Vlek, A. L. M.

AU - Deege, M. P. D.

AU - Frakking, F. N. J.

AU - Overdevest, I. T. M. A.

AU - Bosboom, R. W.

AU - Trienekens, T.

AU - Voorn, G. P.

AU - Ruijs, G. J. H. M.

AU - Wolfhagen, M. J. H. M.

AU - Alblas, J.

AU - Altorf-van der Kuil, W.

AU - Blijboom, L.

AU - Groenendijk, S.

AU - van Heereveld, J.

AU - Hertroys, R.

AU - Monen, J. C.

AU - Notermans, D. W.

AU - Reuland, E. A.

AU - van Triest, M. I.

AU - Wielders, C. C. H.

PY - 2018

Y1 - 2018

N2 - Background Direct health effects of antibiotic resistance are difficult to assess. We quantified the risk of recurrent bacteremia associated with resistance. Methods We extracted antimicrobial susceptibility testing data on blood isolates from the Dutch surveillance system for antimicrobial resistance between 2008 and 2017. First and first recurrent (4-30 days) bacteremia episodes were categorized as susceptible, single nonsusceptible, or co-nonsusceptible to third-generation cephalosporins without or with carbapenems (Enterobacteriaceae), ceftazidime without or with carbapenems (Pseudomonas species), aminopenicillins without or with vancomycin (Enterococcus species), or as methicillin-sensitive/-resistant S. aureus (MSSA/MRSA). We calculated risks of recurrent bacteremia after nonsusceptible vs susceptible first bacteremia, estimated the crude population attributable effect of resistance for the Netherlands, and calculated risks of nonsusceptible recurrent bacteremia after a susceptible first episode. Results Risk ratios for recurrent bacteremia after a single- and co-nonsusceptible first episode, respectively, vs susceptible first episode, were 1.7 (95% confidence interval [CI], 1.5-2.0) and 5.2 (95% CI, 2.1-12.4) for Enterobacteriaceae, 1.3 (95% CI, 0.5-3.1) and 5.0 (95% CI, 2.9-8.5) for Pseudomonas species, 1.4 (95% CI, 1.2-1.7) and 1.6 (95% CI, 0.6-4.2) for Enterococcus species, and 1.6 (95% CI, 1.1-2.4) for MRSA vs MSSA. The estimated population annual number of recurrent bacteremias associated with nonsusceptibility was 40. The risk of nonsusceptible recurrent bacteremia after a susceptible first episode was at most 0.4% (Pseudomonas species). Conclusions Although antibiotic nonsusceptibility was consistently associated with higher risks of recurrent bacteremia, the estimated annual number of additional recurrent episodes in the Netherlands (40) was rather limited.

AB - Background Direct health effects of antibiotic resistance are difficult to assess. We quantified the risk of recurrent bacteremia associated with resistance. Methods We extracted antimicrobial susceptibility testing data on blood isolates from the Dutch surveillance system for antimicrobial resistance between 2008 and 2017. First and first recurrent (4-30 days) bacteremia episodes were categorized as susceptible, single nonsusceptible, or co-nonsusceptible to third-generation cephalosporins without or with carbapenems (Enterobacteriaceae), ceftazidime without or with carbapenems (Pseudomonas species), aminopenicillins without or with vancomycin (Enterococcus species), or as methicillin-sensitive/-resistant S. aureus (MSSA/MRSA). We calculated risks of recurrent bacteremia after nonsusceptible vs susceptible first bacteremia, estimated the crude population attributable effect of resistance for the Netherlands, and calculated risks of nonsusceptible recurrent bacteremia after a susceptible first episode. Results Risk ratios for recurrent bacteremia after a single- and co-nonsusceptible first episode, respectively, vs susceptible first episode, were 1.7 (95% confidence interval [CI], 1.5-2.0) and 5.2 (95% CI, 2.1-12.4) for Enterobacteriaceae, 1.3 (95% CI, 0.5-3.1) and 5.0 (95% CI, 2.9-8.5) for Pseudomonas species, 1.4 (95% CI, 1.2-1.7) and 1.6 (95% CI, 0.6-4.2) for Enterococcus species, and 1.6 (95% CI, 1.1-2.4) for MRSA vs MSSA. The estimated population annual number of recurrent bacteremias associated with nonsusceptibility was 40. The risk of nonsusceptible recurrent bacteremia after a susceptible first episode was at most 0.4% (Pseudomonas species). Conclusions Although antibiotic nonsusceptibility was consistently associated with higher risks of recurrent bacteremia, the estimated annual number of additional recurrent episodes in the Netherlands (40) was rather limited.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85047549792&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/29228127

U2 - https://doi.org/10.1093/cid/cix1076

DO - https://doi.org/10.1093/cid/cix1076

M3 - Article

C2 - 29228127

SN - 1058-4838

VL - 66

SP - 1651

EP - 1657

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 11

ER -

Antibiotic Resistance and the Risk of Recurrent Bacteremia

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