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Article: Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity
Title | Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity |
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Authors | |
Keywords | Cephalosporin Community Escherichia Coli Extended-Spectrum Beta-Lactamase (Esbl) Resistance |
Issue Date | 2013 |
Publisher | Elsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/ijid |
Citation | International Journal Of Infectious Diseases, 2013, v. 17 n. 2, p. e120-e124 How to Cite? |
Abstract | Objectives: This study assessed the impact of discordant empirical antibiotic therapy on the outcome of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. Methods: The clinical features and outcomes of a cohort of patients hospitalized with ESBL E. coli bacteremia between 2007 and 2008 were retrospectively reviewed. The effect of different antimicrobial regimens on patient outcomes was analyzed. Results: ESBL E. coli accounted for 24.2% (207/857) of E. coli bacteremia cases. The urinary tract (43.6%) was the most common source of infection, followed by the hepatobiliary tract (23.0%). Discordant empirical antibiotic therapy was given to 52.0% patients. Admission to the intensive care unit was associated with the use of a carbapenem as empirical antibiotic therapy (p<. 0.001). Univariate analysis revealed no significant differences in 30-day mortality rates between patients receiving concordant and discordant empirical antibiotic therapy (23.5% vs. 19.8%, p=. 0.526), carbapenem and non-carbapenem empirical antibiotic therapy (29.8% vs. 19.1%, p=. 0.118), beta-lactam/beta-lactam inhibitor combinations (BLBLIs) and non-BLBLIs empirical antibiotic therapy (20.3% vs. 22.3%, p=. 0.734), cephalosporin and non-cephalosporin empirical antibiotic therapy (19.7% vs. 22.6%, p=. 0.639), and fluoroquinolone and non-fluoroquinolone empirical antibiotic therapy (8.3% vs. 22.4%, p=. 0.251). The findings were confirmed by multivariate analysis. Conclusions: Despite a high proportion of discordant empirical antibiotic therapy, ESBL production had little effect on 30-day mortality. Whether the observation can be applied to different ESBL types is unknown and warrants further study. © 2012 International Society for Infectious Diseases. |
Persistent Identifier | http://hdl.handle.net/10722/182359 |
ISSN | 2023 Impact Factor: 4.8 2023 SCImago Journal Rankings: 1.435 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | To, KKW | en_US |
dc.contributor.author | Lo, WU | en_US |
dc.contributor.author | Chan, JFW | en_US |
dc.contributor.author | Tse, H | en_US |
dc.contributor.author | Cheng, VCC | en_US |
dc.contributor.author | Ho, PL | en_US |
dc.date.accessioned | 2013-04-23T08:20:04Z | - |
dc.date.available | 2013-04-23T08:20:04Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.citation | International Journal Of Infectious Diseases, 2013, v. 17 n. 2, p. e120-e124 | en_US |
dc.identifier.issn | 1201-9712 | en_US |
dc.identifier.uri | http://hdl.handle.net/10722/182359 | - |
dc.description.abstract | Objectives: This study assessed the impact of discordant empirical antibiotic therapy on the outcome of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. Methods: The clinical features and outcomes of a cohort of patients hospitalized with ESBL E. coli bacteremia between 2007 and 2008 were retrospectively reviewed. The effect of different antimicrobial regimens on patient outcomes was analyzed. Results: ESBL E. coli accounted for 24.2% (207/857) of E. coli bacteremia cases. The urinary tract (43.6%) was the most common source of infection, followed by the hepatobiliary tract (23.0%). Discordant empirical antibiotic therapy was given to 52.0% patients. Admission to the intensive care unit was associated with the use of a carbapenem as empirical antibiotic therapy (p<. 0.001). Univariate analysis revealed no significant differences in 30-day mortality rates between patients receiving concordant and discordant empirical antibiotic therapy (23.5% vs. 19.8%, p=. 0.526), carbapenem and non-carbapenem empirical antibiotic therapy (29.8% vs. 19.1%, p=. 0.118), beta-lactam/beta-lactam inhibitor combinations (BLBLIs) and non-BLBLIs empirical antibiotic therapy (20.3% vs. 22.3%, p=. 0.734), cephalosporin and non-cephalosporin empirical antibiotic therapy (19.7% vs. 22.6%, p=. 0.639), and fluoroquinolone and non-fluoroquinolone empirical antibiotic therapy (8.3% vs. 22.4%, p=. 0.251). The findings were confirmed by multivariate analysis. Conclusions: Despite a high proportion of discordant empirical antibiotic therapy, ESBL production had little effect on 30-day mortality. Whether the observation can be applied to different ESBL types is unknown and warrants further study. © 2012 International Society for Infectious Diseases. | en_US |
dc.language | eng | en_US |
dc.publisher | Elsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/ijid | en_US |
dc.relation.ispartof | International Journal of Infectious Diseases | en_US |
dc.rights | NOTICE: this is the author’s version of a work that was accepted for publication in International Journal Of Infectious Diseases. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in International Journal Of Infectious Diseases, 2013, v. 17 n. 2, p. e120-e124. DOI: http://dx.doi.org/10.1016/j.ijid.2012.09.008 | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Cephalosporin | en_US |
dc.subject | Community | en_US |
dc.subject | Escherichia Coli | en_US |
dc.subject | Extended-Spectrum Beta-Lactamase (Esbl) | en_US |
dc.subject | Resistance | en_US |
dc.title | Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity | en_US |
dc.type | Article | en_US |
dc.identifier.email | To, KKW: kelvinto@hkucc.hku.hk | en_US |
dc.identifier.email | Chan, JFW: jfwchan@hku.hk | en_US |
dc.identifier.email | Tse, H: htse@hkucc.hku.hk | en_US |
dc.identifier.email | Ho, PL: plho@hkucc.hku.hk | en_US |
dc.identifier.authority | To, KKW=rp01384 | en_US |
dc.identifier.authority | Chan, JFW=rp01736 | en_US |
dc.identifier.authority | Tse, H=rp00519 | en_US |
dc.identifier.authority | Ho, PL=rp00406 | en_US |
dc.description.nature | postprint | en_US |
dc.identifier.doi | 10.1016/j.ijid.2012.09.008 | en_US |
dc.identifier.pmid | 23098812 | - |
dc.identifier.scopus | eid_2-s2.0-84873414928 | en_US |
dc.identifier.hkuros | 219369 | - |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-84873414928&selection=ref&src=s&origin=recordpage | en_US |
dc.identifier.volume | 17 | en_US |
dc.identifier.issue | 2 | en_US |
dc.identifier.spage | e120 | en_US |
dc.identifier.epage | e124 | en_US |
dc.identifier.isi | WOS:000314643800007 | - |
dc.publisher.place | United Kingdom | en_US |
dc.identifier.scopusauthorid | To, KKW=14323807300 | en_US |
dc.identifier.scopusauthorid | Lo, WU=35558916700 | en_US |
dc.identifier.scopusauthorid | Chan, JFW=24278817900 | en_US |
dc.identifier.scopusauthorid | Tse, H=7006070596 | en_US |
dc.identifier.scopusauthorid | Cheng, VCC=55220273400 | en_US |
dc.identifier.scopusauthorid | Ho, PL=7402211363 | en_US |
dc.identifier.issnl | 1201-9712 | - |