Epidemiology, Clinical Features, and Antimicrobial Resistance of Invasive Escherichia Coli Disease in Patients Admitted in Tertiary Care Hospitals.
Open Forum Infect Dis
; 10(2): ofad026, 2023 Feb.
Article
en En
| MEDLINE
| ID: mdl-36817744
ABSTRACT
Background:
Invasive Escherichia coli disease (IED), including bloodstream infection, sepsis, and septic shock, can lead to high hospitalization and mortality rates. This multinational study describes the clinical profile of patients with IED in tertiary care hospitals.Methods:
We applied clinical criteria of systemic inflammatory response syndrome (SIRS), sepsis, or septic shock to patients hospitalized with culture-confirmed E coli from urine or a presumed sterile site. We assessed a proposed clinical case definition against physician diagnoses.Results:
Most patients with IED (N = 902) were adults aged ≥60â years (76.5%); 51.9%, 25.1%, and 23.0% of cases were community-acquired (CA), hospital-acquired (HA), and healthcare-associated (HCA), respectively. The urinary tract was the most common source of infection (52.3%). Systemic inflammatory response syndrome, sepsis, and septic shock were identified in 77.4%, 65.3%, and 14.1% of patients, respectively. Patients >60â years were more likely to exhibit organ dysfunction than those ≤60â years; this trend was not observed for SIRS. The case-fatality rate (CFR) was 20.0% (60-75â years, 21.5%; ≥75â years, 22.2%), with an increase across IED acquisition settings (HA, 28.3%; HCA, 21.7%; CA, 15.2%). Noticeably, 77.8% of patients initiated antibiotic use on the day of culture sample collection. A total of 65.6% and 40.8% of E coli isolates were resistant to ≥1 agent in ≥1 or ≥2 drug class(es). A 96.1% agreement was seen between the proposed clinical case definition and physician's diagnoses of IED.Conclusions:
This study contributes valuable, real-world data about IED severity. An accepted case definition could promote timely and accurate diagnosis of IED and inform the development of novel preventative strategies.
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Bases de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
/
Screening_studies
Idioma:
En
Revista:
Open Forum Infect Dis
Año:
2023
Tipo del documento:
Article
País de afiliación:
Bélgica