{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:35:35Z","timestamp":1787495735552,"version":"build-2736575974"},"reference-count":47,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,5,6]]},"abstract":"<jats:p>\n                    Although there has been an increasing incidence of bacteremia caused by extended-spectrum beta-lactamase (ESBL)\u2013producing Enterobacteriaceae (ESBL-E) across South East Asia, there are sparse data from the Lao PDR, where laboratory capacity for antimicrobial resistance surveillance is limited. We, therefore, retrospectively reviewed bacteremia caused by ESBL-producing\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    and\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    between 2010 and 2014 at Mahosot Hospital, Vientiane, Lao PDR. Clinical and laboratory data relating to all episodes of ESBL-E bacteremia were reviewed over the 5-year period and compared with non\u2013ESBL-E bacteremia. Blood cultures positive for\n                    <jats:italic>E. coli<\/jats:italic>\n                    or\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    were identified retrospectively from laboratory records. Clinical and laboratory data were extracted from research databases and case notes and analyzed using STATA. Between 2010 and 2014, we identified 360 patients with\n                    <jats:italic>E. coli<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 249) or\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    (\n                    <jats:italic>n<\/jats:italic>\n                    = 111) bacteremia, representing 34.8% of all patients with clinically significant bacteremia\n                    <jats:italic>.<\/jats:italic>\n                    Seventy-two (20%) isolates produced ESBL;\n                    <jats:italic>E. coli<\/jats:italic>\n                    accounted for 15.3% (55\/360) and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    for 4.7% (17\/360), respectively. The incidence of ESBL-producing\n                    <jats:italic>E. coli<\/jats:italic>\n                    bacteremia rose during the study period. By multiple logistic analysis, reported antibiotic use in the previous week was significantly associated with ESBL positivity (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001, odds ratio 3.89). Although multiresistant, most ESBL-producing\n                    <jats:italic>E. coli<\/jats:italic>\n                    and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    remained susceptible to meropenem (65\/65; 100%) and amikacin (64\/65; 98.5%). We demonstrated an alarming increase in the incidence of ESBL-E as a cause of bacteremia in Vientiane during the study period. This has implications for empiric therapy of sepsis in Laos, and ongoing surveillance is essential.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.19-0304","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T03:00:33Z","timestamp":1583809233000},"page":"1137-1143","source":"Crossref","is-referenced-by-count":13,"title":["Bacteremia Caused by Extended-Spectrum Beta-Lactamase\u2013Producing Enterobacteriaceae in Vientiane, Lao PDR: A 5-Year Study"],"prefix":"10.4269","volume":"102","author":[{"given":"Ko","family":"Chang","sequence":"first","affiliation":[{"name":"Adult Infectious Diseases Ward, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayaphet","family":"Rattanavong","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayfong","family":"Mayxay","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"},{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;"},{"name":"Institute of Research and Education Development (IRED), University of Health Sciences, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valy","family":"Keoluangkhot","sequence":"additional","affiliation":[{"name":"Adult Infectious Diseases Ward, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viengmon","family":"Davong","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manivanh","family":"Vongsouvath","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manophab","family":"Luangraj","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J. H.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"},{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Newton","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos;"},{"name":"Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;"},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A. 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