File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Clinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity

TitleClinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicity
Authors
KeywordsCephalosporin
Community
Escherichia Coli
Extended-Spectrum Beta-Lactamase (Esbl)
Resistance
Issue Date2013
PublisherElsevier 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?
AbstractObjectives: 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 Identifierhttp://hdl.handle.net/10722/182359
ISSN
2015 Impact Factor: 2.229
2015 SCImago Journal Rankings: 1.148
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTo, KKWen_US
dc.contributor.authorLo, WUen_US
dc.contributor.authorChan, JFWen_US
dc.contributor.authorTse, Hen_US
dc.contributor.authorCheng, VCCen_US
dc.contributor.authorHo, PLen_US
dc.date.accessioned2013-04-23T08:20:04Z-
dc.date.available2013-04-23T08:20:04Z-
dc.date.issued2013en_US
dc.identifier.citationInternational Journal Of Infectious Diseases, 2013, v. 17 n. 2, p. e120-e124en_US
dc.identifier.issn1201-9712en_US
dc.identifier.urihttp://hdl.handle.net/10722/182359-
dc.description.abstractObjectives: 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.languageengen_US
dc.publisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/locate/ijiden_US
dc.relation.ispartofInternational Journal of Infectious Diseasesen_US
dc.rightsNOTICE: 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.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCephalosporinen_US
dc.subjectCommunityen_US
dc.subjectEscherichia Colien_US
dc.subjectExtended-Spectrum Beta-Lactamase (Esbl)en_US
dc.subjectResistanceen_US
dc.titleClinical outcome of extended-spectrum beta-lactamase-producing Escherichia coli bacteremia in an area with high endemicityen_US
dc.typeArticleen_US
dc.identifier.emailTo, KKW: kelvinto@hkucc.hku.hken_US
dc.identifier.emailChan, JFW: jfwchan@hku.hken_US
dc.identifier.emailTse, H: htse@hkucc.hku.hken_US
dc.identifier.emailHo, PL: plho@hkucc.hku.hken_US
dc.identifier.authorityTo, KKW=rp01384en_US
dc.identifier.authorityChan, JFW=rp01736en_US
dc.identifier.authorityTse, H=rp00519en_US
dc.identifier.authorityHo, PL=rp00406en_US
dc.description.naturepostprinten_US
dc.identifier.doi10.1016/j.ijid.2012.09.008en_US
dc.identifier.pmid23098812-
dc.identifier.scopuseid_2-s2.0-84873414928en_US
dc.identifier.hkuros219369-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84873414928&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume17en_US
dc.identifier.issue2en_US
dc.identifier.spagee120en_US
dc.identifier.epagee124en_US
dc.identifier.isiWOS:000314643800007-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridTo, KKW=14323807300en_US
dc.identifier.scopusauthoridLo, WU=35558916700en_US
dc.identifier.scopusauthoridChan, JFW=24278817900en_US
dc.identifier.scopusauthoridTse, H=7006070596en_US
dc.identifier.scopusauthoridCheng, VCC=55220273400en_US
dc.identifier.scopusauthoridHo, PL=7402211363en_US

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats