A Retrospective Analysis of Risk Factors and Patient Outcomes of Bloodstream Infection with Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Chinese Tertiary Hospital

摘要

Objective:The present study assessed risk factors and patient outcomes of bloodstream infection (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli).Methods:A retrospective study was performed to analyze risk factors and patient outcomes of BSI caused by extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) in one Chinese tertiary hospital over a 7.5-year period. The clinical characteristics of patients infected with ESBL-producing and non-ESBL-producing E. coli were compared. Predictors of 30-day mortality in patients with E. coli BSI were also identified in our study.Results:The results of drug sensitivity showed that quinolones, aminoglycosides, β-lactam/β-lactamase inhibitor combinations (BLICs) and trimethoprim/sulfamethoxazole exhibited significant differences between the ESBL and non-ESBL groups. Of the 963 patients with E. coli BSI, 57.6% developed ESBL-EC. Multivariate analysis showed that biliary tract infection (BTI) [P2 [P=0.016,OR (95% CI): 2.453 (1.179-5.103)], gastrointestinal catheterization [P=0.004, OR (95% CI): 2.525 (1.333-4.782)] were significantly associated with 30-day mortality. According to Kaplan-Meier survival analysis, we found that in SOFA2, gastrointestinal catheterization. Compared to carbapenems, the BLICs had preferable effect to treat?patients with ESBL-EC BSI. Notably, patients with severe illness were inlcined to use carbapenems, which affected the analysis results.?Therefore, we suggest that BLICs could be recommended to treat mild patients with ESBL-EC bacteremia.? 2020 Xiao et al.