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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.

Objective:  

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.

Methods:  

Retrospective casenote review of patients who were culture-positive between 1st January 2004 and 31st May 2004.

Results:  

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 0–48). 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 Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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