296例成人大肠埃希菌血流感染的危险因素及预后分析

目的 探讨成人产超广谱β内酰胺酶(ESBL)大肠埃希菌血流感染的危险因素及对患者预后的影响.方法 采用病例对照的研究方法,回顾性收集2017年1月—2019年8月大肠埃希菌血流感染患者296例,其中产ESBL大肠埃希菌血流感染患者191例为观察组,以同期非产ESBL大肠埃希菌血流感染患者105例为对照组,进行血流感染的...

Risk factors and prognosis analysis for 296 cases of Escherichia coli bloodstream infection in adults

Objective To evaluate the risk factors for Escherichia coli bloodstream infections and the associated patient prognosis.Methods A total of 191 patients with extended-spectrumβ-lactamase(ESBLs)-producing E.coli bloodstream infections from January 2017 to August 2019 were reviewed retrospectively in a case-control study.Another 105 patients with bloodstream infection due to non-ESBLs-producing E.coli during the same period were taken as control group to analyze the risk factors for bloodstream infection.The patients were compared in terms of outcome(poor outcome,53 patients;favorable outcome,243 patients)to identify the prognostic factors.Results Among the 296 E.coli strains isolated from the 296 patients,191(64.5%)produced ESBLs.More than 60%of the E.coli isolates were resistant to ampicillin,cefazolin,cefuroxime,piperacillin,tetracycline,ampicillin-sulbactam,cefotaxime,ceftriaxone,and cefoperazone.The ESBLs-producing E.coli strains showed significantly higher resistant rates than non-ESBLs-producing strains to common antibacterial agents except carbapenems,amikacin,tetracycline,and trimethoprim-sulfamethoxazole(P<0.05).Poor outcome was reported in significantly higher percentage of patients with ESBLs-producing strain than in the patients with non-ESBLs-producing strain(21.5%versus 11.4%,P<0.05).Multivariate analysis showed that indwelling urinary catheter was an independent risk factor for bloodstream infection with ESBLs-producing E.coli.Septic shock,ICU admission,low hemoglobin,and low albumin were independent risk factors for poor prognosis.Conclusions Indwelling urinary catheter was an independent risk factor for bloodstream infection with ESBLs-producing E.coli.Septic shock,ICU admission,low hemoglobin,and low albumin should be addressed seriously when treating bloodstream infections for the purpose to improve patient outcome.