[Clinical and prognostic analysis of decompensated cirrhosis patients Escherichia coli bloodstream infections].
OBJECTIVE
To investigate the clinical characteristic and drug resistance of decompensated cirrhosis patients bloodstream infections causing by Escherichia coli, and determine risk factors for mortality among patients with bloodstream infections.


METHODS
The clinical data and drug susceptibility of decompensated cirrhosis patients Escherichia coli bloodstream infections from 2009 to 2012 in 302 hospital of PLA were retrospectively analyzed. Univariable and multivariable Logistic regression was used to identify independent risk factors for all-cause mortality.


RESULTS
A total 211 strains of E. coli were isolated from decompensated cirrhosis inpatients, 80 strains ESBLs detecting were positive, positive rate was 37. 9%. Most of infection source were uncertain. The drug resistance of ESBLs positive strains was higher than ESBLs negative strains, but no statistical difference existed in age, sex, basic disease, infection source, peak temperature, white blood cell count, the percentage of neutrophils between ESBLs positive strains and negative strains. 154 patients were survived and 57 patients were died after treatment, with a mortality of 27. 01%. On multivariate analysis, independent risk factors for in-hospital mortality were old age [odds ratio (OR) = 2.429], abnormal pulse (OR = 2.977), liver failure (OR = 11.159), hepatic encephalopathy (OR = 2.524 ) , septic shock (OR = 8.837), acute kidney injury (OR = 3.758), gastrointestinal bleeding(OR = 4.118). Body temperature of > 39 °C (OR = 0.301) had protective effect to lower mortality. A Logistic probobility model was created by adding points for each independent risk factor, and had a c-statistic of 0.898.


CONCLUSIONS
Due to decompensated cirrhosis patients Escherichia ecu bloodstream infection severity and had prognosis, early effective antimicrobial therapy and severe complication prevention should be taken to reduce mortality.
He
H
Weiping
Yang
Y
Liu
Bao
B
Chunmei
Zhang
Z
Wenjin
Cui
C
Enbo
Cai
C
Shaoping
Fan
F
Zhenping
D016470:Bacteremia; D003141:Communicable Diseases; D004926:Escherichia coli; D004927:Escherichia coli Infections; D017052:Hospital Mortality; D006801:Humans; D008103:Liver Cirrhosis; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic