Time-to-positivity in patients with Escherichia coli bacteraemia

Peralta, Galo; Roiz, M. P.; Sánchez, María Blanca; Garrido, Jose C Martinez; Ceballos, Begoña; Rodríguez-Lera, María José; Mateos, Fátima; Benito, I. De

doi:10.1111/j.1469-0691.2007.01817.x

Cited by 54 publications

(43 citation statements)

References 33 publications

(40 reference statements)

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“…This result differs from those of studies of bacterial bloodstream infections, which have shown that a shorter time to positivity is associated with increased mortality (18,24,36). Given these contrasting results, we considered potential confounding variables that may have affected our study.…”

Section: Discussionmentioning

confidence: 61%

Effect of Antifungal Therapy Timing on Mortality in Cancer Patients with Candidemia

Taur

Cohen

Dubnow

et al. 2010

Antimicrob Agents Chemother

114

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Prior studies have shown that delays in treatment are associated with increased mortality in patients with candidemia. The purpose of this study was to measure three separate time periods comprising the diagnosis and treatment of candidemia and to determine which one(s) is associated with hospital mortality. Patients with blood cultures positive for Candida spp. were identified. Subjects were excluded if no antifungal therapy was given or if there was preexisting antifungal therapy. Collected data included the time from blood culture collection to positivity (incubation period), the time from blood culture positivity to provider notification (provider notification period), and the time from provider notification to the first dose of antifungal given (antifungal initiation period). These times were assessed as predictors of inpatient mortality. A repeat analysis was done with adjustments for age, sex, race, underlying cancer, catheter removal, APACHE III score, acute renal failure, neutropenia, and non-Candida albicans species. A total of 106 episodes of candidemia were analyzed. The median incubation time was 32.1 h and was associated with mortality (univariate hazard ratio per hour, 1.025; P ‫؍‬ 0.001). The median provider notification and antifungal initiation periods were 0.3 and 7.5 h, respectively, and were not associated with mortality. Adjusted analysis yielded similar results. For cancer patients with candidemia, the incubation period accounts for a significant amount of time, compared with the provider notification and antifungal initiation times, and is associated with in-hospital mortality. Strategies to shorten the incubation time, such as utilizing rapid molecularly based diagnostic methods, may help reduce in-hospital mortality.

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Section: Discussionmentioning

confidence: 61%

Effect of Antifungal Therapy Timing on Mortality in Cancer Patients with Candidemia

Taur

Cohen

Dubnow

et al. 2010

Antimicrob Agents Chemother

114

View full text Add to dashboard Cite

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“…Later mortality was more frequently seen in females where the UT was the source of origin. Lower mortality has been noted previously in patients whose bacteraemia originated from the UT, and it has been suggested that concentrations of bacteria in the blood may be lower in these cases (Jauréguy et al, 2007;Lefort et al, 2011;Peralta et al, 2007).…”

Section: Discussionmentioning

confidence: 77%

Characterization of Escherichia coli bloodstream isolates associated with mortality

Miajlović

Aogáin

Collins

et al. 2016

Journal of Medical Microbiology

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Extra-intestinal pathogenic Escherichia coli (ExPEC) are the predominant cause of Gramnegative bloodstream infections. In this study, 20 E. coli isolates that were the causative agents of bacteraemia and subsequent mortality were characterized. Whole-genome sequencing was used to define the predominant sequence types (ST) among the isolates and to identify virulence factors associated with pathogenicity of ExPEC. The ability of the isolates to resist killing by both serum and polymorphonuclear leukocytes (PMNLs) was also assessed. In line with global trends, ST131 occurred most frequently among the bloodstream isolates and all isolates of this sequence type were multidrug resistant. Other common STs included ST73 and ST69. All isolates encoded multiple virulence factors across a range of categories, including factors involved in adhesion, immune evasion, iron acquisition and synthesis of toxins. None of these factors could be associated with serum and neutrophil resistance. The majority of isolates were resistant to the bactericidal action of serum and PMNLs, and most of those that were sensitive were isolated from patients with compromised immunity. INTRODUCTIONRates of Escherichia coli bacteraemia have increased steadily in recent years (de Kraker et al., 2013). Concurrently, rates of multidrug resistant (MDR) E. coli infections are on the rise. In particular, the predominant extra-intestinal pathogenic E. coli (ExPEC) global lineage sequence type (ST) 131 is frequently associated with fluoroquinolone resistance and production of extended-spectrum b-lactamases (ESBLs) (Nicolas-Chanoine et al., 2014).Unlike other commensals found in the gastrointestinal tract (GT), ExPEC have an associated array of virulence factors that allow survival outside of this setting. Many of these virulence factors have been horizontally acquired and vary from strain to strain (Dobrindt et al., 2003). They can be classed into adhesins, protectins, iron acquisition systems and toxins (Köhler & Dobrindt, 2011). Adhesins, such as the type 1 fimbriae, contribute to colonization of the urinary tract (UT) epithelium (Kaper et al., 2004;Mulvey et al., 2000; Ulett et al., 2013). The UT is the most common source of infection in cases of bacteraemia (Russo & Johnson, 2003). Access to the bloodstream follows an ascending infection in which the F1C and P fimbriae play a role (Kaper et al., 2004;Mulvey et al., 2000). Many other adhesins have been associated with pathogenesis of E. coli, including S fimbriae, the Hek adhesin, antigen 43, the temperature-sensitive haemagglutinin (Tsh), F9 fimbriae and the Iha adhesin (Fagan & Smith, 2007; Köhler & Dobrindt, 2011;Ulett et al., 2007;Wurpel et al., 2014).ExPEC that cross the tubular epithelial cell barrier and enter the bloodstream can induce a powerful host inflammatory response, resulting in sepsis. Sepsis is associated with high rates of morbidity and mortality (Laupland et al., 2008;Russo & Johnson, 2003). To survive in the bloodstream, E. coli have to resist immune defences of the host, includin...

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“…13,14,17 These studies indicated that a rapid TTP was correlated with disease severity, source of infection, and poor patient outcome. Additional studies of E. coli and K. pneumoniae, 15,16,25 Gram-negative bacilli bacteremia, 19 and another study of Gram-positive and Gram-negative bacteria together, 18 indicated similar associations with rapid TTP. Numerous studies evaluated the association of TTP for Gram-negative bacteremia; however, the present study is the first to investigate the association of clinical outcome and TTP of blood cultures in patients with NTS bacteremia.…”

Section: Discussionmentioning

confidence: 88%

Time to positivity in blood cultures of adults with nontyphoidal Salmonella bacteremia

Lin

Hsu

Huang

et al. 2016

Journal of Microbiology, Immunology and Infection

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Time-to-positivity in patients with Escherichia coli bacteraemia

Cited by 54 publications

References 33 publications

Effect of Antifungal Therapy Timing on Mortality in Cancer Patients with Candidemia

Effect of Antifungal Therapy Timing on Mortality in Cancer Patients with Candidemia

Characterization of Escherichia coli bloodstream isolates associated with mortality

Time to positivity in blood cultures of adults with nontyphoidal Salmonella bacteremia

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