Bacteraemia due to Escherichia coli in a Danish university hospital, 1986-1990.
433 episodes of E. coli bactereaemia over a 5-year period in a Danish university hospital were studied with special emphasis on possible differences between nosocomial (NO) and community-acquired (CA) cases. Data from 186 males and 247 females with ages ranging from 9 days to 94 years were recorded. The average incidence of E. coli bacteraemia was 24.4 episodes/10,000 admissions/year. Older females accounted for the largest number of cases, which reflected the composition of the background population. The highest risk of infection was in males 80-89 years of age. The highest frequency of NO infections was in the departments of Intensive Care (90%) Orthopaedic Surgery (87%) and Haematology (80%). The most common focus was the urinary tract, with 72% of the episodes with a known focus, while the biliary tract was the focus in 14%. NO bacteraemia was independently related to immunosuppressive therapy, presence of predisposing factors, polymicrobial bacteraemia and presence of a non-urinary tract focus. A urinary tract focus was associated with CA bacteraemia, monomicrobial infection, female sex and a normal or elevated total white blood cell count. Patients with NO bacteraemia had predisposing factors more often than had CA patients, especially haematological malignancies and immunosuppressive therapy. Lack of a known bacterial focus was more common in NO than CA episodes, particularly among patients with haematologic malignancies. The overall mortality was 21%. Increased mortality was independently related to leukopenia (45%), immunosuppressive therapy and NO bacteraemia.
Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Denmark.
B
B
Olesen
H J
HJ
Kolmos
F
F
Orskov
I
I
Orskov
A
A
Gottschau
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D004927:Escherichia coli Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006785:Hospitals, University / Q000639:trends*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents