{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T08:12:06Z","timestamp":1777191126814,"version":"3.51.4"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T00:00:00Z","timestamp":1720224000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T00:00:00Z","timestamp":1720224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Antimicrob Resist Infect Control"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Before the COVID-19 pandemic there has been a constant increase in antimicrobial resistance (AMR) of <jats:italic>Escherichia coli<\/jats:italic>, the most common cause of urinary tract infections and bloodstream infections. The aim of this study was to investigate the impact of the COVID-19 pandemic on extended-spectrum \u03b2-lactamase (ESBL) production in urine and blood <jats:italic>E. coli<\/jats:italic> isolates in Finland to improve our understanding on the source attribution of this major multidrug-resistant pathogen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Susceptibility test results of 564,233 urine (88.3% from females) and 23,860 blood <jats:italic>E. coli<\/jats:italic> isolates (58.8% from females) were obtained from the nationwide surveillance database of Finnish clinical microbiology laboratories. Susceptibility testing was performed according to EUCAST guidelines. We compared ESBL-producing <jats:italic>E. coli<\/jats:italic> proportions and incidence before (2018\u20132019), during (2020\u20132021), and after (2022) the pandemic and stratified these by age groups and sex.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The annual number of urine <jats:italic>E. coli<\/jats:italic> isolates tested for antimicrobial susceptibility decreased 23.3% during 2018\u20132022 whereas the number of blood <jats:italic>E. coli<\/jats:italic> isolates increased 1.1%. The annual proportion of ESBL-producing <jats:italic>E. coli<\/jats:italic> in urine <jats:italic>E. coli<\/jats:italic> isolates decreased 28.7% among males, from 6.9% (average during 2018\u20132019) to 4.9% in 2022, and 28.7% among females, from 3.0 to 2.1%. In blood <jats:italic>E. coli<\/jats:italic> isolates, the proportion decreased 32.9% among males, from 9.3 to 6.2%, and 26.6% among females, from 6.2 to 4.6%. A significant decreasing trend was also observed in most age groups, but risk remained highest among persons aged\u2009\u2265\u200960 years.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The reduction in the proportions of ESBL-producing <jats:italic>E. coli<\/jats:italic> was comprehensive, covering both specimen types, both sexes, and all age groups, showing that the continuously increasing trends could be reversed. Decrease in international travel and antimicrobial use were likely behind this reduction, suggesting that informing travellers about the risk of multidrug-resistant bacteria, hygiene measures, and appropriate antimicrobial use is crucial in prevention. Evaluation of infection control measures in healthcare settings could be beneficial, especially in long-term care.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13756-024-01427-z","type":"journal-article","created":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T19:01:53Z","timestamp":1720292513000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Impact of the COVID-19 pandemic on extended-spectrum \u03b2-lactamase producing Escherichia coli in urinary tract and blood stream infections: results from a nationwide surveillance network, Finland, 2018 to 2022"],"prefix":"10.1186","volume":"13","author":[{"given":"Heikki","family":"Ilmavirta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jukka","family":"Ollgren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kati","family":"R\u00e4is\u00e4nen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuure","family":"Kinnunen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antti Juhani","family":"Hakanen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaisu","family":"Rantakokko-Jalava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jari","family":"Jalava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Outi","family":"Lyytik\u00e4inen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,6]]},"reference":[{"key":"1427_CR1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"CJ Murray","year":"2022","unstructured":"Murray CJ, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A, et al. 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