title: Risk factors for bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli in a Turkish hospital.
abstract: BACKGROUND
  Bloodstream infection caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens has become a serious concern worldwide. The purpose of this study was to identify risk factors for bacteremia due to ESBL-producing Escherichia coli in a Turkish hospital.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with E. coli bacteremia in a tertiary care centre from January 2007 to October 2011. Data from patients such as demographic features, underlying conditions, and antibiotic exposure were analysed.
  
  
  RESULTS
  A total of 113 patients with bacteremia due to E. coli were included and data from patients with ESBL-producing E. coli (case patients) were compared to those with non-ESBL-producing E. coli (control patients). The frequency of ESBL producers was 38.9% (44/113). Exposure to fluoroquinolones and cephalosporins, history of intra-abdominal surgery intervention, and presence of central venous catheteter and urinary catheteter were more frequently detected among case patients (P < 0.05). Independent risk factors for bacteremia due to ESBL-producing E. coli were exposure to fluoroquinolones (OR 13.39, 95% CI 1.28-140.03) and cephalosporins (OR 3.48, 95% CI 1.03-11.74).
  
  
  CONCLUSIONS
  Previous use of fluoroquinolone and cephalosporin in patients with bacteremia caused by E. coli increased the risk for ESBL-producing strains.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey. onurkaya@med.sdu.edu.tr
authors.forename: Onur
authors.initials: O
authors.lastname: Kaya
authors.forename: Fusun Zeynep
authors.initials: FZ
authors.lastname: Akcam
authors.forename: Ibak
authors.initials: I
authors.lastname: Gonen
authors.forename: Onur
authors.initials: O
authors.lastname: Unal
authors.forename: Tennure
authors.initials: T
authors.lastname: Ceylan
mesh_terms: D000368:Aged; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology*; D004926:Escherichia coli / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers; D014421:Turkey / Q000453:epidemiology; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases