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- Title
Analysis of 4758 Escherichia coli bacteraemia episodes: predictive factors for isolation of an antibiotic-resistant strain and their impact on the outcome.
- Authors
M. Ortega; F. Marco; A. Soriano; M. Almela; J. A. Martínez; A. Muñoz; J. Mensa
- Abstract
Objectives To describe the predictive factors for the isolation of fluoroquinolone-resistant or extended- spectrum β-lactamase (ESBL)-producing Escherichia coli and their impact on bacteraemia outcome. Methods Analysis of E. coli bacteraemia episodes prospectively collected through a blood culture surveillance programme from January 1991 to December 2007. Results Out of 18 080 episodes, 4758 (26%) E. coli bacteraemias were reported in the period of study. Mortality was noted in 440 cases (9%). Fluoroquinolone-resistant strains were reported in 1300 (27%) cases and ESBL-producing strains in 211 cases (4%). One hundred and seventy-eight strains out of 211 (84%) ESBL-producing E. coli were isolated since 2001. The two main independent risk factors for mortality were shock (OR: 10.28, P P n = 203, 16%, P n = 110, 52%, P P P P P = 0.03); urinary catheterization (OR: 1.88, P = 0.001); and previous β-lactam antibiotic therapy (OR: 2.81, P Conclusions Inappropriate empirical therapy was the strongest independent factor that we could modify to improve mortality in E. coli bacteraemia and was more frequent in cases caused by fluoroquinolone-resistant or ESBL-producing strains. Nosocomial acquisition, urinary catheterization and previous therapy with a fluoroquinolone or β-lactam were predictive factors for infection with an antibiotic-resistant strain.
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2009, Vol 63, Issue 3, p568
- ISSN
0305-7453
- Publication type
Academic Journal
- DOI
10.1093/jac/dkn514