title: Absence of excess mortality in critically ill patients with nosocomial Escherichia coli bacteremia.
abstract: OBJECTIVE
  To evaluate excess mortality in critically ill patients with Escherichia coli bacteremia after adjustment for severity of illness.
  
  
  METHODS
  Retrospective (1992-2000), pairwise-matched (1:2), risk-adjusted cohort study.
  
  
  METHODS
  Fifty-four-bed ICU in a university hospital including a medical and surgical ICU, a unit for care after cardiac surgery, and a burns unit.
  
  
  METHODS
  ICU patients with nosocomial E. coli bacteremia (defined as cases; n = 64) and control-patients without nosocomial bloodstream infection (n = 128).
  
  
  METHODS
  Case-patients were matched with control-patients on the basis of the Acute Physiology and Chronic Health Evaluation (APACHE) II system: an equal APACHE II score (+/- 2 points) and diagnostic category. In addition, control-patients were required to have an ICU stay at least as long as that of the respective case-patients prior to onset of the bacteremia.
  
  
  RESULTS
  The overall rate of appropriate antibiotic therapy in patients with E. coli bacteremia was high (93%) and such therapy was initiated soon after onset of the bacteremia (0.6 +/- 1.0 day). ICU patients with E. coli bacteremia had more acute renal failure. No differences were noted between case-patients and control-patients in incidence of acute respiratory failure, hemodynamic instability, or age. No differences were observed in length of mechanical ventilation or length of ICU stay. In-hospital mortality rates for cases and controls were not different (43.8% and 45.3%, respectively; P = .959).
  
  
  CONCLUSIONS
  After adjustment for disease severity and acute illness and in the presence of adequate antibiotic therapy, no excess mortality was found in ICU patients with E. coli bacteremia.
authors.affiliation: Department of Intensive Care, Ghent University Hospital, Ghent, Belgium.
authors.forename: Stijn
authors.initials: S
authors.lastname: Blot
authors.forename: Koenraad
authors.initials: K
authors.lastname: Vandewoude
authors.forename: Eric
authors.initials: E
authors.lastname: Hoste
authors.forename: Jan
authors.initials: J
authors.lastname: De Waele
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kint
authors.forename: Fanny
authors.initials: F
authors.lastname: Rosiers
authors.forename: Dirk
authors.initials: D
authors.lastname: Vogelaers
authors.forename: Francis
authors.initials: F
authors.lastname: Colardyn
mesh_terms: D018806:APACHE; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D001530:Belgium / Q000453:epidemiology; D015331:Cohort Studies; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D017052:Hospital Mortality; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D016015:Logistic Models; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents