Risk factors and treatment outcomes of community-onset bacteraemia caused by
extended-spectrum β-lactamase-producing Escherichia coli
- Affiliated Author(s)
- 류성열
- Alternative Author(s)
- Ryu, Seong Yeol
- Journal Title
- International Journal of Antimicrobial Agents
- ISSN
- 0924-8579
- Issued Date
- 2010
- Abstract
- The purpose of this study was to identify risk factors for extended-spectrum -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 ESBLproducers
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). ESBLproducing
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.
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