[Predictive factors of ESBL versus non-ESBL Escherichia coli bacteraemia and influence of resistance on the mortality of the patients].
OBJECTIVE
To analyze predictor factors of extended-spectrum betalactamasa (ESBL)-producing E. coli and its repercussion in mortality.


METHODS
Observational and comparative study of a cohort of non-paediatric admitted patients with E. coli bacteraemia (EB).


RESULTS
153 EB (22% ESBL-producing strains). Risk factors associated with ESBLB: previous antibiotic treatment (OR 2.61; 95% CI 1.1-6.19), severity Winston score ≤2 (OR 9.83, 95% CI 3.42-28.26) and health-related acquired infection (OR 5.35; 95% CI 1.57-18.27). Related mortality rate was 21%, being independent risk factors: cancer (OR 4.02; 95% CI 1.08-14.82), high severity of underlying disease (McCabe) (OR 7.69; 95% CI 1.96-30.09) and critical severity of illness at onset (Winston) (OR 48.89; 95% CI 11.58-206.97). Inappropriate empirical therapy was more frequent in EBSL-producing group (67%, p<0.05).


CONCLUSIONS
Previous antibiotic treatment, severity Winston score ≤2 and health-related acquisition are factors associated to ESBL EB. EBSL-producing strains or inadequate treatment were not associated to higher mortality. Factors statistically associated to mortality were cancer, severity of underlying diseases and critical severity of illness at onset.
García Hernández
Ana
A
Servicio de Medicina Interna-Infecciosas, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España.
García-Vázquez
Elisa
E
Gómez Gómez
Joaquín
J
Canteras
Manuel
M
Hernandez-Torres
Alicia
A
Ruiz Gómez
Joaquín
J
D016470:Bacteremia / Q000188:drug therapy* / Q000401:mortality*; D024881:Drug Resistance, Bacterial; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D001618:beta-Lactamases
D001618:beta-Lactamases