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Article: Bacteremia caused by Escherichia coli producing extended-spectrum beta-lactamase: A case-control study of risk factors and outcomes

TitleBacteremia caused by Escherichia coli producing extended-spectrum beta-lactamase: A case-control study of risk factors and outcomes
Authors
Issue Date2002
PublisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365548.asp
Citation
Scandinavian Journal Of Infectious Diseases, 2002, v. 34 n. 8, p. 567-573 How to Cite?
AbstractA case-control study was conducted in order to identify the risk factors associated with bloodstream infection caused by Escherichia coli producing extended-spectrum β-lactamase (ESBL) and to determine the outcomes of infected patients. Risk factors associated with ESBL production, according to univariate analysis, included a history of recent hospitalization [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.1-8.9; p < 0.001], severe underlying diseases (OR 15, 95% CI 4.4-51.5; p < 0.001), prior exposure to urinary catheters (OR 8.3, 95% CI 3.2-21.7; p < 0.001) and nosocomial (OR 14.1, 95% CI 6.1-32.8; p < 0.001) or urinary (OR 3.6, 95% CI 1.7-7.4; p < 0.001) origin of the bacteria. Multivariate analysis revealed that severe underlying diseases (OR 31.2, 95% CI 6.7-144; p < 0.001) and nosocomial (OR 16.5, 95% CI 5.6-49; p < 0.001) and urinary origins (OR 7.8, 95% CI 2.6-23.8; p < 0.001) of the bacteria were independently associated with ESBL production in bacteremic E. coli. Crude mortality in case patients was more than twice as high as that in controls (p = 0.04). Production of ESBL increased the risk of inappropriate initial therapy (OR 95.6, 95% CI 27.4-334.2; p < 0.001). Treatment failed in 4/7 case patients treated with ceftazidime to which the isolate was susceptible in vitro. Our findings have implications for the choice of empirical therapy in nosocomial urinary tract infection.
Persistent Identifierhttp://hdl.handle.net/10722/78918
ISSN
2015 Impact Factor: 1.366
2015 SCImago Journal Rankings: 0.714
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorHo, PLen_HK
dc.contributor.authorChan, WMen_HK
dc.contributor.authorTsang, KWTen_HK
dc.contributor.authorWong, SSYen_HK
dc.contributor.authorYoung, Ken_HK
dc.date.accessioned2010-09-06T07:48:23Z-
dc.date.available2010-09-06T07:48:23Z-
dc.date.issued2002en_HK
dc.identifier.citationScandinavian Journal Of Infectious Diseases, 2002, v. 34 n. 8, p. 567-573en_HK
dc.identifier.issn0036-5548en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78918-
dc.description.abstractA case-control study was conducted in order to identify the risk factors associated with bloodstream infection caused by Escherichia coli producing extended-spectrum β-lactamase (ESBL) and to determine the outcomes of infected patients. Risk factors associated with ESBL production, according to univariate analysis, included a history of recent hospitalization [odds ratio (OR) 4.3, 95% confidence interval (CI) 2.1-8.9; p < 0.001], severe underlying diseases (OR 15, 95% CI 4.4-51.5; p < 0.001), prior exposure to urinary catheters (OR 8.3, 95% CI 3.2-21.7; p < 0.001) and nosocomial (OR 14.1, 95% CI 6.1-32.8; p < 0.001) or urinary (OR 3.6, 95% CI 1.7-7.4; p < 0.001) origin of the bacteria. Multivariate analysis revealed that severe underlying diseases (OR 31.2, 95% CI 6.7-144; p < 0.001) and nosocomial (OR 16.5, 95% CI 5.6-49; p < 0.001) and urinary origins (OR 7.8, 95% CI 2.6-23.8; p < 0.001) of the bacteria were independently associated with ESBL production in bacteremic E. coli. Crude mortality in case patients was more than twice as high as that in controls (p = 0.04). Production of ESBL increased the risk of inappropriate initial therapy (OR 95.6, 95% CI 27.4-334.2; p < 0.001). Treatment failed in 4/7 case patients treated with ceftazidime to which the isolate was susceptible in vitro. Our findings have implications for the choice of empirical therapy in nosocomial urinary tract infection.en_HK
dc.languageengen_HK
dc.publisherInforma Healthcare. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/00365548.aspen_HK
dc.relation.ispartofScandinavian Journal of Infectious Diseasesen_HK
dc.rightsScandinavian Journal of Infectious Diseases. Copyright © Informa Healthcare.en_HK
dc.subject.meshAge Distributionen_HK
dc.subject.meshAnti-Bacterial Agentsen_HK
dc.subject.meshBacteremia - diagnosis - drug therapy - epidemiologyen_HK
dc.subject.meshCase-Control Studiesen_HK
dc.subject.meshChina - epidemiologyen_HK
dc.subject.meshCohort Studiesen_HK
dc.subject.meshConfidence Intervalsen_HK
dc.subject.meshDrug Therapy, Combination - therapeutic useen_HK
dc.subject.meshEscherichia coli - enzymology - isolation & purificationen_HK
dc.subject.meshEscherichia coli Infections - diagnosis - drug therapy - epidemiologyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMicrobial Sensitivity Testsen_HK
dc.subject.meshMultivariate Analysisen_HK
dc.subject.meshProbabilityen_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSex Distributionen_HK
dc.subject.meshSurvival Rateen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.subject.meshbeta-Lactamases - metabolismen_HK
dc.titleBacteremia caused by Escherichia coli producing extended-spectrum beta-lactamase: A case-control study of risk factors and outcomesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0036-5548&volume=34&spage=567&epage=573&date=2002&atitle=Bacteremia+caused+by+escherichia+coli+producing+extended-spectrum+beta-lactamase:+a+case-control+study+of+risk+factors+and+outcomesen_HK
dc.identifier.emailHo, PL:plho@hkucc.hku.hken_HK
dc.identifier.emailWong, SSY:samsonsy@hkucc.hku.hken_HK
dc.identifier.authorityHo, PL=rp00406en_HK
dc.identifier.authorityWong, SSY=rp00395en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/00365540210147516en_HK
dc.identifier.pmid12238570-
dc.identifier.scopuseid_2-s2.0-0036038438en_HK
dc.identifier.hkuros75014en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036038438&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume34en_HK
dc.identifier.issue8en_HK
dc.identifier.spage567en_HK
dc.identifier.epage573en_HK
dc.identifier.isiWOS:000177912400003-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridHo, PL=7402211363en_HK
dc.identifier.scopusauthoridChan, WM=36338834700en_HK
dc.identifier.scopusauthoridTsang, KWT=7201555024en_HK
dc.identifier.scopusauthoridWong, SSY=13310021400en_HK
dc.identifier.scopusauthoridYoung, K=55254177500en_HK

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