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Risk factors and outcomes of Escherichia coli bacteremia caused by strains that produce CTX-M or non-CTX-M extended-spectrum-beta-lactamases

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Abstract

To determine whether there are differences in risk factors and outcomes among patients with E. coli bacteremia caused by strains that produce CTX-M or non-CTX-M extended-spectrum beta-lactamases. From 1 July 2005 to 30 June 2007, patients with positive blood culture of extended-spectrum β-lactamases (ESBL)-producing E. coli were reviewed. Sixty patients with ESBL-producing E. coli bacteremia were identified. These included 41 (68.3%) isolates with CTX-M β-lactamases. CTX-M-14 accounted for 31 (75.6%) and CTX-M-3 for 9 (22.0%) of the 41 CTX-M isolates. Patients with CTX-M strains were less likely, by univariate analysis, to have significant risk factors for infection including age ≥ 65 years, chronic renal insufficiency, ICU stay at bacteremia onset, central venous catheter use and mechanical ventilation. Multivariate analysis revealed that chronic renal failure and ICU stay were independent predictors. Antibiograms were similar for CTX-M and non-CTX-M producers except that CTX-M strains were significantly more susceptible to cefmetazole (92.7 vs 36.8%, p < 0.0001). The overall mortality and length of hospitalization were not significantly different between the two groups. E. coli with CTX-M β-lactamases was more likely than non-CTX-M strains to invade non-compromised patients. There were no differences in clinical outcomes between the two groups.

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Acknowledgements

The authors would like to thank Dr. Calvin M. Kunin for his critical review of the manuscript. Yee-Chun Chen received grants from the Department of Health, Taiwan (DOH99-TD-B-111-001).

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Authors and Affiliations

  1. Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan, 100

    U.-I. Wu, J.-L. Wang, W.-C. Chen, S.-C. Chang & Y.-C. Chen

  2. Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan

    J.-L. Wang

  3. Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    S.-C. Chang & Y.-C. Chen

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  1. U.-I. Wu
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  2. J.-L. Wang
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  3. W.-C. Chen
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Correspondence to Y.-C. Chen.

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Wu, UI., Wang, JL., Chen, WC. et al. Risk factors and outcomes of Escherichia coli bacteremia caused by strains that produce CTX-M or non-CTX-M extended-spectrum-beta-lactamases. Eur J Clin Microbiol Infect Dis 30, 33–39 (2011). https://doi.org/10.1007/s10096-010-1048-2

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  • DOI: https://doi.org/10.1007/s10096-010-1048-2

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