Predictors of Mortality Among Patients With Community-Onset Infection Due to Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> in Thailand

Apisarnthanarak, Anucha; Kiratisin, P.; Saifon, Piyawan; Kitphati, Rungrueng; Dejsirilert, Surang; Mundy, Linda M.

doi:10.1086/524321

Cited by 13 publications

(14 citation statements)

References 8 publications

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“…The increase in mortality associated with a respiratory or unknown focus compared with the reduction seen for the urogenital tract is consistent with published studies [24]. An underlying respiratory focus may be associated with several risk factors for increased mortality including co-morbidities [5][6][7] and a greater sepsis severity score [6,9]. Conversely, urogenital tract-related bacteraemias may be typically found in otherwise well patients and have a readily modifiable source of infection, such as a urinary catheter.…”

Section: Discussionsupporting

confidence: 84%

“…The English estimates fall towards the bottom of the range of published E. coli bacteraemia 30-day all-cause mortality estimates (10-35%) [5][6][7][8][9][10][11][12][13][14][15][16] although comparability is minimal because of many published studies being based on single centres and/or specific patient populations, which may have specific mortality experiences.…”

Section: Discussionmentioning

confidence: 95%

“…For example, 30-day all-cause mortality among methicillinresistant S. aureus (MRSA) bacteraemia patients in England was estimated as 38% [3] whereas for methicillin-susceptible S. aureus bacteraemia patients an estimate of 27% has been reported [4]. Antimicrobial-resistant extended-spectrum β-lactamase (ESBL) -producing strains of E. coli have also been associated with increased mortality compared with non-ESBLproducing strains [5][6][7]. Published estimates of 30-day allcause mortality among E. coli bacteraemia patients vary dramatically from around 10 to 35% [5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

“…Antimicrobial-resistant extended-spectrum β-lactamase (ESBL) -producing strains of E. coli have also been associated with increased mortality compared with non-ESBLproducing strains [5][6][7]. Published estimates of 30-day allcause mortality among E. coli bacteraemia patients vary dramatically from around 10 to 35% [5][6][7][8][9][10][11][12][13][14][15][16]. Most of these estimates were from single-centre studies examining specific patient populations; among those studies considering more representative patient populations, Schlackow et al [16] studied patients with E. coli bacteraemia detected in a large English region and reported 28-day mortality of 17%.…”

Section: Introductionmentioning

confidence: 99%

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Thirty day all-cause mortality in patients with Escherichia coli bacteraemia in England

Abernethy

Johnson

Guy

et al. 2015

Clinical Microbiology and Infection

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Escherichia coli is the commonest cause of bacteraemia in England, with an incidence of 50.7 cases per 100 000 population in 2011. We undertook a large national study to estimate and identify risk factors for 30-day all-cause mortality in E. coli bacteraemia patients. Records for patients with E. coli bacteraemia reported to the English national mandatory surveillance system between 1 July 2011 and 30 June 2012 were linked to death registrations to determine 30-day all-cause mortality. A multivariable regression model was used to identify factors associated with 30-day all-cause mortality. There were 5220 deaths in 28 616 E. coli bacteraemia patients, a mortality rate of 18.2% (95% CI 17.8-18.7%). Three-quarters of deaths occurred within 14 days of specimen collection. Factors independently associated with increased mortality were: age < 1 year or > 44 years; an underlying respiratory or unknown infection focus; ciprofloxacin non-susceptibility; hospital-onset infection or not being admitted; and bacteraemia occurring in the winter. Female gender and a urogenital focus were associated with a reduction in mortality. This is the first national study of mortality among E. coli bacteraemia patients in England. Interventions to reduce mortality need to be multifaceted and include both primary and secondary healthcare providers. Greater awareness of the risk factors for and symptoms of E. coli bacteraemia may prompt earlier diagnosis and treatment. Changes in antimicrobial resistance patterns need to be monitored for their potential impact on infection and mortality.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Thirty day all-cause mortality in patients with Escherichia coli bacteraemia in England

Abernethy

Johnson

Guy

et al. 2015

Clinical Microbiology and Infection

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“…Extended-spectrum ␤ -lactamases (ESBLs) are enzymes conferring broad resistance to ␤ -lactam antibiotics, including third-generation cephalosporins such as cefotaxime, ceftriaxone, and ceftazidime [3,8,9] . More than 300 variants of ESBL have been described and the majority of these belong to the TEM and SHV family (http://www.lahey.org/Studies/) [10,11] .…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Antimicrobial Susceptibility of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Intensive Care Units of Sanandaj General Hospitals (Kurdistan, Iran)

2009

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This study focused on analyzing the spread of extended-spectrum β-lactamase (ESBL) enzymes among Gram-negative bacteria at intensive care units (ICUs). Between January 2007 and January 2008, 301 consecutive clinical isolates of Gram-negative type were isolated. Of these, 66 strains were collected from patients in ICUs in two major hospitals in Sanandaj (Kurdistan, Iran). The isolates were identified, tested for antimicrobial susceptibility, and analyzed for the presence of ESBL using the double-disk synergy test. Isolates with a positive ESBL phenotype were subjected to PCR for SHV, TEM, OXA and CTX-M β-lactamase gene families. Sixty-six Gram-negative bacteria were isolated from clinical samples of 66 ICU patients. These isolates included 16 Escherichia coli, 28 Enterobacter spp., 5 Pseudomonas spp., 10 Klebsiella pneumoniae, 3 Serratia marcescens and 1 Stenotrophomonas maltophilia. Twenty-three (34.85%) of these isolates were ESBL producing. The ESBL genes detected were SHV, TEM, OXA-1, OXA-2 and CTX-M. The results show the presence of ESBL genes among Gram-negative bacteria in the ICU setting of Sanandaj’s hospitals. There is a need to institute a strict hospital infection control policy and regular surveillance of bacterial resistance to antimicrobial agents.

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Antimicrobial-Resistant Bacteremia in the Elderly: Risk of Previous Hospitalization

Kung

Lee

et al. 2017

International Journal of Gerontology

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Predictors of Mortality Among Patients With Community-Onset Infection Due to Extended-Spectrum β-Lactamase-Producing Escherichia coli in Thailand

Cited by 13 publications

References 8 publications

Thirty day all-cause mortality in patients with Escherichia coli bacteraemia in England

Thirty day all-cause mortality in patients with Escherichia coli bacteraemia in England

Prevalence and Antimicrobial Susceptibility of Extended-Spectrum Beta-Lactamase-Producing Bacteria in Intensive Care Units of Sanandaj General Hospitals (Kurdistan, Iran)

Antimicrobial-Resistant Bacteremia in the Elderly: Risk of Previous Hospitalization

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