The early phase epidemiology of CTX-M type extended spectrum beta lactamase-producing Escherichia coli among hospitalised patients in Belfast
Abstract number: 1134_01_26
McMullan R., Loughrey A., McCalmont M., Rooney P.
To describe the demographics, prevalence of risk factors and outcomes among the first adult hospitalised patients who had colonisation or infection and with ESBL-producing E. coli in a university hospital in Belfast.
Retrospective casenote review of patients who were culture-positive between 1st January 2004 and 31st May 2004.
Of 53 patients identified, 45 casenotes were available for review. The mean age was 73.1 (+14.6) years and 67% of patients were female. Most (56%) patients were in a medicine or elderly care unit at the time of the positive culture. The most frequently recorded comorbidity was haemodialysis-dependence. Many (51%) patients had an indwelling urinary catheter and prior to isolation of the ESBL-producing E. coli, 24.4% of patients had a positive culture for MRSA. The majority (57.8%) of patients had an isolate from urine only; 17.8% had positive blood cultures. The organism had been acquired in hospital in 69% of instances; of these, the mean duration of inpatient stay prior to onset of infection was 45.2 (+52.9) days. Overall, 81% of evaluable patients had received antibiotic therapy within 30 days prior to the first isolate; the mean number of antibiotic-days per patient in this time was 13.9 (range 048). The most frequently consumed class of antibiotic was b-lactam/b-lactamase inhibitor combinations. Of the 45 episodes, 35 (77.8%) were associated with clinically determined infections; of these, 74.2% were successfully treated. Overall, the crude 30-day mortality among patients with such infection was 34.3%; the attributable mortality was estimated at 20%. Among patients with bacteraemia, the attributable mortality was 25%.
|Session name:||XXIst ISTH Congress|
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