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| 標題: | Clinical Impact of Sequence Type 131 in Adults with Community-Onset Monomicrobial Escherichia Coli Bacteremia |
| 作者: | Wang, Jiun-Ling
Lee, Ching-Chi
Lee, Chung-Hsun
Lee, Nan-Yao
Hsieh, Chih-Chia
Hung, Yuan-Pin
Tang, Hung-Jen
Ko, Wen-Chien |
| 貢獻者: | Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Internal Med
Madou Sin Lau Hosp, Dept Internal Med
Chang Jung Christian Univ, Coll Hlth Sci, Grad Inst Med Sci
Natl Cheng Kung Univ, Coll Med, Natl Cheng Kung Univ Hosp, Dept Emergency Med
Minist Hlth & Welf, Tainan Hosp, Dept Internal Med
Chi Mei Med Ctr, Dept Med
Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr |
| 關鍵字: | ST131
ESBL
bacteremia
Escherichia coli
mortality |
| 日期: | 2018-12 |
| 上傳時間: | 2019-11-15 15:46:36 (UTC+8) |
| 出版者: | MDPI |
| 摘要: | Background: The clinical impact of ST (sequence type) 131 in adults with community-onset Escherichia coli bacteremia remains controversial. Methods: Clinical data of 843 adults presenting with community-onset monomicrobial E. coli bacteremia at a medical center between 2008 and 2013 were collected. E. coli isolates were genotyped by a multiplex polymerase chain reaction to detect ST131 and non-ST131 clones. Results: Of 843 isolates from 843 patients with a mean age of 69 years, there were 102 (12.1%) isolates of ST131. The ST131 clone was more likely to be found in the elderly (76.5% vs. 64.0%; p = 0.01) and in nursing-home residents (12.7% vs. 3.8%; p < 0.001) than non-ST131 clones. Furthermore, the ST131 clone was associated with a longer time to appropriate antibiotic therapy (2.6 vs. 0.8 days; p = 0.004) and a higher 28-day mortality rate (14.7% vs. 6.5%, p = 0.003). In the Cox regression analysis with an adjustment of independent predictors, the ST131 clone exhibited a significant adverse impact on 28-day mortality (adjusted odds ratio (aOR), 2.18; p = 0.02). The different impact of the ST131 clone on 28-day mortality was disclosed in the non-ESBL (aOR 1.27; p = 0.70) and ESBL (aOR 10.19; p = 0.048) subgroups. Conclusions: Among adults with community-onset E. coli bacteremia, the ST131 clone was associated with higher 28-day mortality, particularly in those infected by ESBL producers. |
| link: | http://dx.doi.org/10.3390/jcm7120508 |
| 關聯: | Journal of Clinical Medicine, v.7, n.12, 508 |
| 顯示於類別: | [保健營養系(所) ] 期刊論文
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