Bacteremia due to Escherichia coli: a study of 861 episodes.
Escherichia coli accounted for 861 (23.9%) of 3,605 episodes of bacteremia in an 18-year prospective survey at St. Thomas' Hospital, a proportion that changed little during the survey. The most common focus of infection leading to nosocomial and community-acquired bacteremia due to E. coli was the urinary tract. Twenty-six percent of adult female patients with E. coli bacteremia resulting from a urinary tract infection were diabetic. The O antigen serotypes identified most often were O6, O2, O1, O4, O15, and O75; the multiply resistant O15 serotype of E. coli was implicated in a community outbreak of urinary tract infection. Ampicillin resistance in strains causing community-acquired infection increased to the same level as that of strains causing nosocomial infection (almost 50%). The overall mortality was 20.7% and was greater in the presence of shock (52.4% vs. 15.3%). Death due to infection occurred in 2.6% and 10.3%, respectively, of cases with urinary tract and non-urinary tract foci. The adverse influence of inappropriate initial therapy on outcome was more marked in the latter half of the study.
Gransden
W R
WR
Division of Microbiology, United Medical School, Guy's Hospital, London, England.
Eykyn
S J
SJ
Phillips
I
I
Rowe
B
B
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D012737:Sex Factors; D014552:Urinary Tract Infections / Q000150:complications