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Association between dementia and reduced walking ability and 30-day mortality in patients with extended-spectrum beta-lactamase-producing Escherichia coli bacteremia

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Abstract

Previous studies have shown controversial results of factors associated with short-term mortality in patients with extended-spectrum beta-lactamase (ESBL)-producing E. coli bacteremia and no research has investigated the impact of the geriatric assessment criteria on short-term mortality. Our objective was to determine whether dementia and walking ability are associated with 30-day mortality in patients with ESBL-producing E. coli bacteremia. All blood bottle cultures, analyzed from January 2008 to April 2015, in the Bacteriology Department of a 2,600-bed, university-affiliated center, Nantes, France, were retrospectively extracted. Factors associated with short-term mortality in patients with ESBL-producing E. coli bacteremia: 140 patients with an ESBL-producing E. coli bloodstream infection were included; 22 (15.7%) patients died within 30 days following the first positive blood bottle culture of ESBL-producing E.coli. In multivariate analysis, a reduced ability to walk (OR = 0.30; p = 0.021), presence of dementia (OR = 54.51; p = 0.040), a high Sepsis-related Organ Failure Assessment (SOFA) score (OR = 1.69; p < 0.001), presence of neutropenia (OR = 12.94; p = 0.049), and presence of a urinary tract infection (OR = 0.07; p = 0.036), were associated with 30-day mortality. Our findings provide new data showing an independent association between 30-day mortality with dementia and reduced walking ability, in patients with ESBL-producing E. coli bacteremia. These criteria should be considered in the therapeutic management of patients with ESBL-producing E. coli bacteremia.

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Author information

Authors and Affiliations

  1. EE Microbiotas, Hosts, Antibiotics and bacterial Resistances (MiHAR) Institut de Recherche en Santé 2 (IRS2), Université de Nantes, 22 Boulevard Bénoni-Goullin, 44200, Nantes, France

    G. Chapelet, E. Batard & L. de Decker

  2. Clinical Gerontology Department, Centre Hospitalier Universitaire de Nantes, 1 place Alexis-Ricordeau, 44000, Nantes, France

    G. Chapelet, A. S. Boureau, A. Dylis, G. Berrut & L. de Decker

  3. Faculté de médecine—Porte 438, 1 rue Gaston Veil, 44035, Nantes cedex 1, France

    G. Chapelet

  4. Bacteriology Department, Centre Hospitalier Universitaire de Nantes, 1 place Alexis-Ricordeau, 44000, Nantes, France

    G. Herbreteau & S. Corvec

  5. Emergency Department, Centre Hospitalier Universitaire de Nantes, 1 place Alexis-Ricordeau, 44000, Nantes, France

    E. Batard

Authors
  1. G. Chapelet
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  2. A. S. Boureau
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  3. A. Dylis
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  4. G. Herbreteau
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  7. G. Berrut
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Contributions

Chapelet, Boureau, de Decker: concept and design; Chapelet, Boureau, Dylis, Herbreteau, de Decker: acquisition, analysis, and interpretation of data; Corvec, Batard, Berrut, de Decker: drafting and revising the article critically for important intellectual content. All authors reviewed and approved the submitted version of the article.

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Correspondence to G. Chapelet.

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Chapelet, G., Boureau, A.S., Dylis, A. et al. Association between dementia and reduced walking ability and 30-day mortality in patients with extended-spectrum beta-lactamase-producing Escherichia coli bacteremia. Eur J Clin Microbiol Infect Dis 36, 2417–2422 (2017). https://doi.org/10.1007/s10096-017-3077-6

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  • DOI: https://doi.org/10.1007/s10096-017-3077-6

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