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HEALTH

The Claim

In Indian ICU settings, Escherichia coli is the predominant ESBL-producing organism among gram-negative bacterial pathogens.

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The Short Version

Available ICU-focused evidence from India does not support E. coli as the leading ESBL-producing gram-negative organism. The most recent, large ICU datasets cited show Klebsiella pneumoniae is more common than E. coli in ICUs, and multiple bloodstream/hospital studies report Klebsiella as the top ESBL producer. Studies favoring E. coli mainly measure ESBL rates within E. coli or come from non-ICU settings, which cannot establish ICU-wide predominance.

Caveats

  • “Predominant ESBL-producing organism” requires comparing ESBL-positive counts across ICU pathogens (prevalence × ESBL rate), not just higher ESBL rates within E. coli or non-ICU samples.
  • Several supporting studies are UTI/clinical-isolate or single-center reports and are not reliable proxies for ICU-wide gram-negative ESBL epidemiology in India.
  • ICU pathogen distributions vary by site and infection type (e.g., bacteremia vs. all ICU isolates); conclusions should be limited to the specific ICU population and specimen mix studied.

The Receipts

  1. P-67. Bacteremia in the Intensive Care Unit: Pathogen Profiles and Antimicrobial Resistance Trends from January 2022 to June 2024 - PMC

    PMC

  2. Antimicrobial Resistance Profile in ICU Patients Across India: A Multicenter, Retrospective, Observational Study - PMC

    PMC

  3. Prevalence of Extended Spectrum β-lactamase and AmpC β-lactamase among Escherichia coli and Klebsiella pneumoniae in Urinary Tract Infections - Journal of Pure and Applied Microbiology

    Journal of Pure and Applied Microbiology

  4. Extended-Spectrum Beta-Lactamases Producing Escherichia coli and Klebsiella pneumoniae: A Multi-Centric Study Across Karnataka - PMC

    PMC

  5. Prevalence of Extended Spectrum Beta-lactamase and Carbapenemase Producers in Gram Negative Bacteria causing Blood Stream Infect - JCDR

    JCDR

  6. Prevalence, Demographic Distribution, and Antimicrobial Resistance Patterns of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Urinary Tract Infections: A Cross-Sectional Study in a Tertiary Care Hospital in Manipur, India - PMC

    PMC

  7. Prevalence of ESBL Producing E. coli and Klebsiella Species in a Tertiary Care Hospital, Telangana - Journal of Evidence-Based Medicine and Healthcare

    Journal of Evidence-Based Medicine and Healthcare

  8. Prevalence of ESBL Producing Escherichia coli and Klebsiella Species among Clinical Isolates and their in vitro Antimicrobi

    PMC

  9. Prevalence of ESBL in Escherichia coli Isolates Among ICU Patients in a Tertiary Care Hospital - PMC

    PMC

  10. Carbapenem resistant Gram-negative bacteremia in an Indian intensive care unit: A review of the clinical profile and treatment outcome of 50 patients - PMC

    PMC

+ 4 more sources — see the full list on Lenz

Filed Under

Escherichia coliExtended-Spectrum Beta-LactamaseGram-Negative BacteriaIndiaIntensive Care Unit

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