Clinical impact of sequence type 131 in adults with community-onset monomicrobial Escherichia coli Bacteremia

Jiun Ling Wang, Ching Chi Lee, Chung Hsun Lee, Nan Yao Lee, Chih Chia Hsieh, Yuan Pin Hung, Hung Jen Tang, Wen Chien Ko

研究成果: Article同行評審

1 引文 斯高帕斯(Scopus)

摘要

Background: The clinical impact of ST (sequence type) 131 in adults with community-onset Escherichia coli bacteremia remains controversial. Methods: Clinical data of 843 adults presenting with community-onset monomicrobial E. coli bacteremia at a medical center between 2008 and 2013 were collected. E. coli isolates were genotyped by a multiplex polymerase chain reaction to detect ST131 and non-ST131 clones. Results: Of 843 isolates from 843 patients with a mean age of 69 years, there were 102 (12.1%) isolates of ST131. The ST131 clone was more likely to be found in the elderly (76.5% vs. 64.0%; p = 0.01) and in nursing-home residents (12.7% vs. 3.8%; p < 0.001) than non-ST131 clones. Furthermore, the ST131 clone was associated with a longer time to appropriate antibiotic therapy (2.6 vs. 0.8 days; p = 0.004) and a higher 28-day mortality rate (14.7% vs. 6.5%, p = 0.003). In the Cox regression analysis with an adjustment of independent predictors, the ST131 clone exhibited a significant adverse impact on 28-day mortality (adjusted odds ratio (aOR), 2.18; p = 0.02). The different impact of the ST131 clone on 28-day mortality was disclosed in the non-ESBL (aOR 1.27; p = 0.70) and ESBL (aOR 10.19; p = 0.048) subgroups. Conclusions: Among adults with community-onset E. coli bacteremia, the ST131 clone was associated with higher 28-day mortality, particularly in those infected by ESBL producers.

原文English
文章編號508
期刊Journal of Clinical Medicine
7
發行號12
DOIs
出版狀態Published - 2018 12月 1

All Science Journal Classification (ASJC) codes

  • 醫藥 (全部)

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