Risk factors, outcome and impact of empirical antimicrobial treatment in extended-spectrum β-lactamase-producing Escherichia coli bacteraemia.
(2014) In Scandinavian Journal of Infectious Diseases 46(11). p.753-762- Abstract
- Background: To investigate patient characteristics and empirical antimicrobial treatment of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) bacteraemia, to determine risk factors, outcome and impact of empirical antimicrobial treatment. Methods: We performed a retrospective case-control study of all patients diagnosed with ESBL-EC from January 2011 to September 2012. The control group consisted of patients with non-ESBL E. coli bacteraemia. The groups were compared with respect to empirical treatment, risk factors and outcome, using univariate and multivariate analysis. Results: The study consisted of 70 consecutive cases of ESBL-producing and 140 controls of non-ESBL-producing E. coli bacteraemia. ESBL-EC prevalence of... (More)
- Background: To investigate patient characteristics and empirical antimicrobial treatment of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) bacteraemia, to determine risk factors, outcome and impact of empirical antimicrobial treatment. Methods: We performed a retrospective case-control study of all patients diagnosed with ESBL-EC from January 2011 to September 2012. The control group consisted of patients with non-ESBL E. coli bacteraemia. The groups were compared with respect to empirical treatment, risk factors and outcome, using univariate and multivariate analysis. Results: The study consisted of 70 consecutive cases of ESBL-producing and 140 controls of non-ESBL-producing E. coli bacteraemia. ESBL-EC prevalence of bloodstream invasive E. coli isolates was 6.1%. The independent risk factor found for ESBL-EC bacteraemia was a prior culture with ESBL production (p < 0.001). A higher frequency of inappropriate empirical antibiotic treatment (p < 0.001) and a trend towards worse outcome was observed in patients infected with ESBL-EC and empirical guidelines were more often not followed (p = 0.013). If the guidelines were followed this was associated with adequate initial antibiotic treatment (p < 0.001). Conclusions: Patients with ESBL-EC frequently received inappropriate empirical treatment and guidelines were more often not followed. A prior culture of ESBL-producing bacteria was an independent predictor and risk factor for ESBL-EC bacteraemia. Since the prevalence of ESBL-producing E. coli is increasing the importance of adequate guidelines must be emphasized. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/4692131
- author
- Van Aken, Stefanie ; Lund, Nathalie LU ; Ahl, Jonas LU ; Odenholt, Inga LU and Tham, Johan LU
- organization
- publishing date
- 2014
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Scandinavian Journal of Infectious Diseases
- volume
- 46
- issue
- 11
- pages
- 753 - 762
- publisher
- Informa Healthcare
- external identifiers
-
- pmid:25195648
- wos:000343977500003
- scopus:84912011262
- pmid:25195648
- ISSN
- 1651-1980
- DOI
- 10.3109/00365548.2014.937454
- language
- English
- LU publication?
- yes
- id
- 1d82f129-7070-417f-b9c5-405a3550b051 (old id 4692131)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/25195648?dopt=Abstract
- date added to LUP
- 2016-04-01 11:06:04
- date last changed
- 2022-04-28 07:09:53
@article{1d82f129-7070-417f-b9c5-405a3550b051, abstract = {{Background: To investigate patient characteristics and empirical antimicrobial treatment of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) bacteraemia, to determine risk factors, outcome and impact of empirical antimicrobial treatment. Methods: We performed a retrospective case-control study of all patients diagnosed with ESBL-EC from January 2011 to September 2012. The control group consisted of patients with non-ESBL E. coli bacteraemia. The groups were compared with respect to empirical treatment, risk factors and outcome, using univariate and multivariate analysis. Results: The study consisted of 70 consecutive cases of ESBL-producing and 140 controls of non-ESBL-producing E. coli bacteraemia. ESBL-EC prevalence of bloodstream invasive E. coli isolates was 6.1%. The independent risk factor found for ESBL-EC bacteraemia was a prior culture with ESBL production (p < 0.001). A higher frequency of inappropriate empirical antibiotic treatment (p < 0.001) and a trend towards worse outcome was observed in patients infected with ESBL-EC and empirical guidelines were more often not followed (p = 0.013). If the guidelines were followed this was associated with adequate initial antibiotic treatment (p < 0.001). Conclusions: Patients with ESBL-EC frequently received inappropriate empirical treatment and guidelines were more often not followed. A prior culture of ESBL-producing bacteria was an independent predictor and risk factor for ESBL-EC bacteraemia. Since the prevalence of ESBL-producing E. coli is increasing the importance of adequate guidelines must be emphasized.}}, author = {{Van Aken, Stefanie and Lund, Nathalie and Ahl, Jonas and Odenholt, Inga and Tham, Johan}}, issn = {{1651-1980}}, language = {{eng}}, number = {{11}}, pages = {{753--762}}, publisher = {{Informa Healthcare}}, series = {{Scandinavian Journal of Infectious Diseases}}, title = {{Risk factors, outcome and impact of empirical antimicrobial treatment in extended-spectrum β-lactamase-producing Escherichia coli bacteraemia.}}, url = {{http://dx.doi.org/10.3109/00365548.2014.937454}}, doi = {{10.3109/00365548.2014.937454}}, volume = {{46}}, year = {{2014}}, }