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A retrospective analysis of risk factors and outcomes in patients with extended-spectrum beta-lactamase ESBL-producing Escherichia coli bloodstream infections



A retrospective analysis of risk factors and outcomes in patients with extended-spectrum beta-lactamase ESBL-producing Escherichia coli bloodstream infections



Journal of Global Antimicrobial Resistance 2019



Risk factors and outcomes associated with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) bloodstream infections (BSIs) are not yet fully understood. This was a retrospective analysis of patients with E. coli BSI treated over a 4year period. The characteristics of bacteremia caused by ESBL-producing versus non-ESBL-producing E. coli were compared. Factors influencing mortality were also assessed. Of 554 eligible patients, 58.9% developed ESBL-producing E. coli. Multivariate analysis showed that urinary tract infections, stomach tube catheterization, and prior cephalosporin exposure were independent risk factors for the emergence of ESBL-producing E. coli BSI. No significant differences in 30day mortality were seen in patients with BSI caused by ESBL- or non-ESBL-producing E. coli (11.1% versus 9.2%; P=0. 642). Factors independently associated with a higher risk of mortality were previous carbapenem exposure, high APACHE II score, and respiratory tract origin. This study showed that prior urinary tract infections and previous cephalosporin exposure represent significant risk factors for the development of ESBL-producing E. coli BSI. Previous carbapenem exposure, high APACHE II score, and a respiratory tract origin were seen to be independent mortality risk factors in patients with E. coli BSI.

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Accession: 066081580

Download citation: RISBibTeXText

PMID: 30634054

DOI: 10.1016/j.jgar.2018.12.014


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