Yeungnam Univ J Med.  2013 Dec;30(2):83-89.

Risk Factors of Nosocomial Bacteremia of Extended-spectrum beta-Lactamase Producing Escherichia coli

• Ko D
• Moon SM
• Lee JS
• Park YS
• Cho YK

Abstract

BACKGROUND
The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment.
METHODS
A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected.
RESULTS
Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia.
CONCLUSION
Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.

Keyword

Extended-spectrum beta-lactamase; Escherichia coli; Nosocomial; Bacteremia

MeSH Terms

APACHE
Bacteremia*
beta-Lactamases*
Case-Control Studies
Causality
Cross Infection
Escherichia coli*
Escherichia*
Humans
Infection Control
Length of Stay
Mortality
Prevalence
Risk Factors*
Tertiary Healthcare
beta-Lactamases