Wen-Chi Chen1, Chih-Hsin Hung2, Yao-Shen Chen3, Jin-Shiung Cheng1, Susan Shin-Jung Lee3, Fan-Chen Tseng4, Ming-Fang Cheng2,5,6,7, Jiun-Ling Wang8,9. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei 112, Taiwan. 2. Department of Chemical Engineering and Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung 840, Taiwan. 3. Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei 112, Taiwan. 4. Graduate Institute of Basic Medical Science, China Medical University and Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan. 5. Department of Pediatrics, Kaohsiung Veterans General Hospital and School of Medicine, Kaohsiung 813, Taiwan. 6. School of Medicine, National Yang-Ming University, Taipei 112, Taiwan. 7. Department of Nursing, Fooyin University, Kaohsiung 831, Taiwan. 8. Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan. 9. Department of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Abstract
BACKGROUND: This study aimed to investigate the frequency of sequence type (ST) 131 strains and outcome of cirrhotic patients with bloodstream infections (BSIs) caused by extended-spectrum beta-lactamase-producing Escherichia coli (ESBLEC) and non-extended-spectrum beta-lactamase-producing Escherichia coli (NESBLEC). METHODS: The incidence of ST 131 strains, hospital stay, and 30-day re-admission/mortality were compared between 51 ESBLEC and 51 NESBLEC bacteremic patients with cirrhosis. RESULTS: ST 131 strains were found in 35.3% of the ESBLEC group and 0% of the NESBLEC group (p < 0.001). Mean hospital stay was 26.5 days in the ESBLEC group and 17.1 days in the NESBLEC group (p = 0.006). Thirty-day re-admission rates were 11.8% in the ESBLEC group and 5.9% in the NESBLEC group (p = 0.5). ST 131 strains were associated with 30-day re-admission (odds ratio: 4.5, 95% confidence interval: 1.1-18.9). Thirty-day mortality rate was 31.4% in the ESBLEC group and 23.5% in the NESBLEC group (p = 0.4). CONCLUSION: In patients with cirrhosis, the ESBLEC BSIs group had a higher frequency of ST 131 strains and longer hospital stay than the NESBLEC BSIs group with similar 30-day re-admission/mortality. ST 131 strains were associated with 30-day re-admission.
BACKGROUND: This study aimed to investigate the frequency of sequence type (ST) 131 strains and outcome of cirrhotic patients with bloodstream infections (BSIs) caused by extended-spectrum beta-lactamase-producing Escherichia coli (ESBLEC) and non-extended-spectrum beta-lactamase-producing Escherichia coli (NESBLEC). METHODS: The incidence of ST 131 strains, hospital stay, and 30-day re-admission/mortality were compared between 51 ESBLEC and 51 NESBLEC bacteremic patients with cirrhosis. RESULTS:ST 131 strains were found in 35.3% of the ESBLEC group and 0% of the NESBLEC group (p < 0.001). Mean hospital stay was 26.5 days in the ESBLEC group and 17.1 days in the NESBLEC group (p = 0.006). Thirty-day re-admission rates were 11.8% in the ESBLEC group and 5.9% in the NESBLEC group (p = 0.5). ST 131 strains were associated with 30-day re-admission (odds ratio: 4.5, 95% confidence interval: 1.1-18.9). Thirty-day mortality rate was 31.4% in the ESBLEC group and 23.5% in the NESBLEC group (p = 0.4). CONCLUSION: In patients with cirrhosis, the ESBLEC BSIs group had a higher frequency of ST 131 strains and longer hospital stay than the NESBLEC BSIs group with similar 30-day re-admission/mortality. ST 131 strains were associated with 30-day re-admission.
Entities:
Keywords:
Escherichia coli; bacteremia cirrhosis; extended-spectrum beta-lactamase; sequence type 131
Authors: A Courpon-Claudinon; A Lefort; X Panhard; O Clermont; Q Dornic; B Fantin; F Mentré; M Wolff; E Denamur; C Branger Journal: Clin Microbiol Infect Date: 2011-04 Impact factor: 8.067