Clinical Characteristics of Bacteremia Caused by Extended-spectrum Beta-lactamase-producing <i>Escherichia coli</i> at a Tertiary Hospital
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- Namikawa Hiroki
- Department of Infection Control Science, Osaka City University, Graduate School of Medicine, Japan Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, Japan
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- Yamada Koichi
- Department of Infection Control Science, Osaka City University, Graduate School of Medicine, Japan
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- Fujimoto Hiroki
- Department of Infection Control Science, Osaka City University, Graduate School of Medicine, Japan
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- Oinuma Ken-Ichi
- Department of Bacteriology, Osaka City University, Graduate School of Medicine, Japan
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- Tochino Yoshihiro
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, Japan
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- Takemoto Yasuhiko
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, Japan
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- Kaneko Yukihiro
- Department of Bacteriology, Osaka City University, Graduate School of Medicine, Japan
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- Shuto Taichi
- Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, Japan
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- Kakeya Hiroshi
- Department of Infection Control Science, Osaka City University, Graduate School of Medicine, Japan
Bibliographic Information
- Other Title
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- Clinical Characteristics of Bacteremia Caused by Extended-spectrum Beta-lactamase-producing <italic>Escherichia coli</italic> at a Tertiary Hospital
- Clinical characteristics of bacteremia caused by extended-spectrum beta-lactamase-producing Escherichia coli at a tertiary hospital
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Abstract
<p>Objective In recent years, infection caused by extended-spectrum beta-lactamase (ESBL)-producing organisms has become an important issue. However, comparative studies of the bacteremia caused by ESBL Enterobacteriaceae and non-ESBL Enterobacteriaceae are extremely rare in Japan. This study aimed to assess the risk factors and prognosis of patients with bacteremia due to ESBL Escherichia coli (E. coli). </p><p>Methods The medical records of 31 patients with ESBL E. coli bacteremia and 98 patients with non-ESBL E. coli bacteremia who had been admitted to Osaka City University Hospital between January 2011 and June 2015 were retrospectively reviewed. The patient backgrounds, risk factors for infection, and prognosis were evaluated. </p><p>Results The male-to-female ratio, mean age, underlying disease, leukocyte count, and C-reactive protein (CRP) level did not differ between the patients in the ESBL E. coli bacteremia and non-ESBL E. coli bacteremia groups. The mean Sequential Organ Failure Assessment (SOFA) score for patients with ESBL and non-ESBL E. coli bacteremia were 3.6 and 3.8, respectively. Further, the mortality did not differ between the two groups (9.7% vs 9.2%). However, the independent predictors associated with ESBL E. coli bacteremia according to a multivariate analysis were the use of immunosuppressive drugs or corticosteroids (p=0.048) and quinolones (p=0.005) prior to isolation. The mortality did not differ between the carbapenem and tazobactam/piperacillin (TAZ/PIPC) or cefmetazole (CMZ) groups for the patients with ESBL E. coli bacteremia. </p><p>Conclusion Whenever we encountered patients with a history of immunosuppressive drug, corticosteroid, quinolone administration, it was necessary to perform antibiotic therapy while keeping the risk of ESBL E. coli in mind. </p>
Journal
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- Internal Medicine
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Internal Medicine 56 (14), 1807-1815, 2017
The Japanese Society of Internal Medicine
