Bibliometric Analysis of Research on ESBL-Producing Escherichia coli in Healthcare Settings

Baslan Fatih Hakimi, Brian Eka Rachman, Riski Nabila

Abstract


This study mapped the global research landscape on ESBL–producing E. coli in healthcare settings and examined trends in scientific output, major contributors, and thematic focus. Articles indexed in Scopus up to 2025 were analyzed using Bibliometrix (R) and VOSviewer to evaluate publication growth, country and institutional productivity, leading authors, core journals, collaboration networks, and keyword patterns. A total of 4,032 documents were identified, showing substantial expansion since the mid-2000s, especially after 2010. The United States, China, and several European and Asian countries emerged as dominant contributors. Keyword and network analyses revealed a thematic shift from early enzyme-focused studies toward high-risk clones, carbapenemase co-production, therapeutic strategies, and one health–related transmission. Overall, the field appears mature yet continuously evolving, reflecting broader global antimicrobial resistance trends.

Keywords


esbl-producing escherichia coli; healthcare-associated infections; antimicrobial resistance; bibliometric analysis; scopus

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References


Tüzün T, Sayin Kutlu S, Kutlu M, Kaleli I. Risk factors for community-onset urinary tract infections caused by extended-spectrum ?-lactamase-producing Escherichia coli. Turk J Med Sci. 2019;49(6):1206–1211. doi:10.3906/sag-1902-24

Moran RA, Baomo L, Doughty EL, Guo Y, Ba X, van Schaik W, et al. Extended-spectrum ?-lactamase genes traverse the Escherichia coli populations of intensive care unit patients, staff, and environment. Microbiol Spectr. 2023;11(2):e05074-22. doi:10.1128/spectrum.05074-22

Akpaka PE, Vaillant A, Wilson C, Jayaratne P. Extended spectrum beta-lactamase (ESBL) produced by Gram-negative bacteria in Trinidad and Tobago. Int J Microbiol. 2021;2021:5582755. doi:10.1155/2021/5582755

Zhang S, Liao X, Ding T, Ahn J. Role of ?-lactamase inhibitors as potentiators in antimicrobial chemotherapy targeting Gram-negative bacteria. Antibiotics (Basel). 2024;13(3):260. doi:10.3390/antibiotics13030260

Xiao T, Wu Z, Shi Q, Zhang X, Zhou Y, Yu X. A retrospective analysis of risk factors and outcomes in patients with extended-spectrum ?-lactamase-producing Escherichia coli bloodstream infections. J Glob Antimicrob Resist. 2019;17:147–156. doi:10.1016/j.jgar.2018.12.014

San T, Aung YK, Aung MT, Htun YM, Aye TT, Oo NN, et al. High burden of infections caused by ESBL-producing MDR Escherichia coli in paediatric patients, Yangon, Myanmar. JAC Antimicrob Resist. 2021;3(1):dlab011. doi:10.1093/jacamr/dlab011

Passas I. Bibliometric analysis: the main steps. Encyclopedia. 2024;4(2):1014–1025. doi:10.3390/encyclopedia4020065

Kemeç A, Alt?nay AT. Sustainable energy research trend: a bibliometric analysis using VOSviewer, RStudio Bibliometrix, and CiteSpace software tools. Sustainability. 2023;15(4):3618. doi:10.3390/su15043618

Jiang ST, Liu YG, Zhang L, Sang XT, Xu YY, Lu X. Immune-related adverse events: a bibliometric analysis. Front Immunol. 2022;13:1096806. doi:10.3389/fimmu.2022.1096806

Zhang J, Yang X, Fang J, Cheng Q, Ding H, Sun Y, et al. Evolution of associating liver partition and portal vein ligation for staged hepatectomy from 2012 to 2021: a bibliometric analysis. Int J Surg. 2022;103:106648. doi:10.1016/j.ijsu.2022.106648

Farina S, Fevola G, Adduci A, Maio A, Lontano A, Ricciardi W, et al. Trends in antimicrobial resistance education research: a bibliometric analysis. One Health. 2025;21:101120. doi:10.1016/j.onehlt.2025.101120

Karanika S, Karantanos T, Arvanitis M, Grigoras C, Mylonakis E. Fecal colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae and risk factors among healthy individuals: a systematic review and meta-analysis. Clin Infect Dis. 2016;63(3):310–318. doi:10.1093/cid/ciw283

Woerther PL, Burdet C, Chachaty E, Andremont A. Trends in human fecal carriage of extended-spectrum ?-lactamases in the community: toward the globalization of CTX-M. Clin Microbiol Rev. 2013;26(4):744–758. doi:10.1128/CMR.00023-13

Pitout JD, Laupland KB. Extended-spectrum ?-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis. 2008;8(3):159–166. doi:10.1016/S1473-3099(08)70041-0

Ramos S, Silva V, Dapkevicius M de LE, Caniça M, Tejedor-Junco MT, Igrejas G, et al. Escherichia coli as commensal and pathogenic bacteria among food-producing animals: health implications of extended spectrum ?-lactamase (ESBL) production. Animals (Basel). 2020;10(12):2239. doi:10.3390/ani10122239

Yartey SNA, Kungu F, Asantewaa AA, Donkor ES. Extended spectrum beta-lactamase-producing bacterial clones in West Africa: a systematic review and meta-analysis from a One Health perspective. Sci Rep. 2025;15(1). doi:10.1038/s41598-025-10695-7

Wu JJ, Chen HM, Ko WC, Wu HM, Tsai SH, Yan JJ. Prevalence of extended-spectrum ?-lactamases in Proteus mirabilis in a Taiwanese university hospital, 1999–2005. Diagn Microbiol Infect Dis. 2008;60(2):169–175. doi:10.1016/j.diagmicrobio.2007.08.004

Quincho-Lopez A, Pacheco-Mendoza J. Research trends and collaboration patterns on polymyxin resistance: a bibliometric analysis (2010–2019). Front Pharmacol. 2021;12:702937. doi:10.3389/fphar.2021.702937

Sweileh WM, Al-Jabi SW, Zyoud SH, Sawalha AF, Abu-Taha AS. Global research output in antimicrobial resistance among uropathogens: a bibliometric analysis (2002–2016). J Glob Antimicrob Resist. 2018;13:104–114. doi:10.1016/j.jgar.2017.11.017

Lin JY, Lai JK, Chen JY, Cai JY, Yang ZD, Yang LQ, et al. Global insights into MRSA bacteremia: a bibliometric analysis and future outlook. Front Microbiol. 2025;15:1516584. doi:10.3389/fmicb.2024.1516584

Sweileh WM. Global research activity on antimicrobial resistance in food-producing animals. Arch Public Health. 2021;79(1). doi:10.1186/s13690-021-00572-w

Ablakimova N, Smagulova GA, Rachina S, Mussina AZ, Zare A, Mussin NM, et al. Bibliometric analysis of global research output on antimicrobial resistance among pneumonia pathogens (2013–2023). Antibiotics (Basel). 2023;12(9):1411. doi:10.3390/antibiotics12091411

Day MJ, Hopkins KL, Wareham DW, Toleman MA, Elviss N, Randall L, et al. Extended-spectrum ?-lactamase-producing Escherichia coli in human-derived and food-chain-derived samples from England, Wales and Scotland. Lancet Infect Dis. 2019;19(12):1325–1335. doi:10.1016/S1473-3099(19)30273-7

Bastidas-Caldes C, Romero-Alvarez D, Valdez-Vélez V, Morales RD, Montalvo-Hernández A, Gomes-Dias C, et al. Extended-spectrum beta-lactamases producing Escherichia coli in South America: a systematic review with a One Health perspective. Infect Drug Resist. 2022;15:5759–5779. doi:10.2147/IDR.S371845

Chen C, Li SL, Xu YY, Liu J, Graham DW, Zhu YG. Characterising global antimicrobial resistance research explains why One Health solutions are slow in development: an application of AI-based gap analysis. Environ Int. 2024;187:108680. doi:10.1016/j.envint.2024.108680

Fang X, Kang L, Qiu YF, Bai Y, et al. Bibliometric analysis of WoS core database output: growth productive trends of “Y. enterocolitica” and “Y. enterocolitica & Crohn disease” research from 1900 to 2022. Front Cell Infect Microbiol. 2023;13:1129996. doi:10.3389/fcimb.2023.1129996

Alsharksi A, Mustapha A, Sirekbasan S, Gürkök Tan T. Bibliometric analysis of new inhibitors targeting extended spectrum beta-lactamase enzymes. Abant Sagl?k Bilim ve Teknol Derg. 2025;5(1):26–38. Available from: https://dergipark.org.tr/en/pub/sabited/issue/91342/1615945

?ahin S, Sivri N, Akpinar ?, Çinçin ZB, Sönmez VZ. A comprehensive bibliometric overview: antibiotic resistance and Escherichia coli in natural water. Environ Sci Pollut Res Int. 2021;28:32256–32263. doi:10.1007/s11356-021-14084-1

Bradford PA. Extended-spectrum ?-lactamases in the 21st century: characterization, epidemiology, and detection. Clin Microbiol Rev. 2001;14(4):933–951. doi:10.1128/CMR.14.4.933-951.2001

Rossolini GM, D’Andrea MM, Mugnaioli C. The spread of CTX-M-type extended-spectrum ?-lactamases. Clin Microbiol Infect. 2008;14 Suppl 1:33–41. doi:10.1111/j.1469-0691.2007.01867.x




DOI: https://doi.org/10.32502/sm.v16i2.10667

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