Escherichia coli bacteraemia in patients with and without haematological malignancies: a study of strain characters and recurrent episodes.
We compared serotypes, virulence factors and susceptibility to antibiotics of Escherichia coli strains isolated from 282 patients with bacteraemia. Thirty-five of these were neutropenic patients with haematological malignancy and 247 were patients with a normal or raised total white blood cell count and no haematological malignancy. Strains isolated from recurrent bacteraemia were also bio- and ribotyped. Overall, no significant difference was found between O serogroups, K antigens, serum sensitivity, production of haemolysin, expression of P-fimbriae and patterns of antibiotic susceptibility in the two groups of strains. The haematological patients more often than the non-haematological patients had an unknown focus of infection, recurrent bacteraemia, shorter intervals between recurrences and recurrences caused by identical strains. Despite a well-defined focus, six of eight non-haematological patients had recurrences with a strain different from the strain isolated in a previous episode. A possible connection between shorter intervals and recurrence with identical strains is discussed. We suggest that strains from recurrent E. coli bacteraemia are sent to a reference laboratory for serotyping and possibly ribotyping.
Olesen
B
B
Department of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Denmark.
Kolmos
H J
HJ
Orskov
F
F
Orskov
I
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016470:Bacteremia / Q000150:complications / Q000382:microbiology* / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000150:complications / Q000382:microbiology*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000382:microbiology*; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009503:Neutropenia / Q000382:microbiology*; D012008:Recurrence; D012703:Serotyping; D014774:Virulence
D000900:Anti-Bacterial Agents