| dc.description.abstract | Introduction: Some Enterobacteriaceae can produce enzymes (extended spectrum betalactamases
or ESBLs) which make them resistant to certain antibiotics. In Sweden, the
number of ESBL-septicemias are increasing and Escherichia coli (E. coli) is the dominant
bacteria. There are difficulties to initially identify which septic patients are to be suspected of
infection with multi-resistant Enterobacteriaceae, sometimes resulting in delayed effective
treatment. There are several potential risk factors to consider when assessing whether a septic
patient might be infected with ESBL-producing bacteria. Therefore, it would be valuable to
have indicating factors to facilitate the identification of patients at risk in order to choose
effective empiric treatment.
Methods: The patients were selected based on the occurrence of E. coli-positive blood
cultures between 1 Jan - 31 Dec 2016. Analyzed factors were age, sex, previous
hospitalization, recent surgery, use of urinary catheter, living in nursing home, previous
antibiotic treatment, immunosuppression, hospital care abroad, hospital vs. community
acquired infection, previous faeces culture with ESBL-E. coli and previous urine and/or blood
culture with ESBL-E. coli. A multivariate analysis was performed for variables with a univariate
p-value <0.2 and statistical significance was established at £0.05.
Results: A total of 470 patients were evaluated, with 485 cases of septicemia. Three
parameters gained statistical significance: hospital care abroad (OR=3.4, 95%CI=1.1-10.4,
p=0.037), previously ESBL-positive in faeces (OR=8.1, 95%CI=1.0-65.4, p=0.050) and
previously ESBL-positive in blood and/or urine (OR=54.5, 95%CI=11.2-256.5, p<0.001).
Conclusion: In this retrospectively conducted survey of patients with E. coli bacteremia, we
found that previously detected ESBL-E. coli in blood, urine or faeces and previous hospital
care abroad were predicting factor for bacteremia with ESBL-producing E. coli.
KEY WORDS: ESBL; E. coli; bacteremia; risk factors | sv |
