Risk factors and treatment outcomes of community-onset bacteraemia caused by extended-spectrum beta-lactamase-producing Escherichia coli.
The purpose of this study was to identify risk factors for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli amongst community-onset bacteraemia and to evaluate treatment outcomes. From the database of a nationwide surveillance programme for bacteraemia, data from patients with community-onset E. coli bacteraemia were analysed. Patients with ESBL-producing E. coli bacteraemia were compared with those with non-ESBL-producing bacteraemia. The overall proportion of ESBL-producers was 9.5% (82/865) amongst community-onset E. coli bacteraemia cases. Healthcare-associated infection, underlying liver disease and primary bacteraemia were significant independent factors associated with ESBL-producing E. coli bacteraemia (P<0.05). There was a trend toward mortality being higher in the ESBL group compared with the non-ESBL group (15.0% vs. 7.6%; P=0.096). ESBL production was found to be an independent factor associated with mortality after adjusting for confounding variables (odds ratio=2.99, 95% confidence interval 1.01-8.84; P=0.048), along with severe sepsis, higher Pitt bacteraemia score, primary bacteraemia, pneumonia and underlying liver disease (P<0.05). ESBL-producing E. coli is a significant cause of bacteraemia, even in patients with community-onset infections, predicting higher mortality, particularly in patients with primary bacteraemia, underlying liver disease or healthcare-associated infection.
Kang
Cheol-In
CI
Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea.
Song
Jae-Hoon
JH
Chung
Doo Ryeon
DR
Peck
Kyong Ran
KR
Ko
Kwan Soo
KS
Yeom
Joon-Sup
JS
Ki
Hyun Kyun
HK
Son
Jun Seong
JS
Lee
Seung Soon
SS
Kim
Yeon-Sook
YS
Jung
Sook-In
SI
Kim
Shin-Woo
SW
Chang
Hyun-Ha
HH
Ryu
Seong Yeol
SY
Kwon
Ki Tae
KT
Lee
Hyuck
H
Moon
Chisook
C
Shin
Sang Yop
SY
D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D017714:Community-Acquired Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D003428:Cross Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D004926:Escherichia coli / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D029968:Escherichia coli Proteins / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D016896:Treatment Outcome; D001618:beta-Lactamases / Q000096:biosynthesis*
D029968:Escherichia coli Proteins; D001618:beta-Lactamases