Clinical Impact of Sequence Type 131 in Adults with Community-Onset Monomicrobial Escherichia Coli Bacteremia

doi:10.3390/jcm7120508

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Title:	Clinical Impact of Sequence Type 131 in Adults with Community-Onset Monomicrobial Escherichia Coli Bacteremia
Authors:	Wang, Jiun-Ling Lee, Ching-Chi Lee, Chung-Hsun Lee, Nan-Yao Hsieh, Chih-Chia Hung, Yuan-Pin Tang, Hung-Jen Ko, Wen-Chien
Contributors:	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
Keywords:	ST131 ESBL bacteremia Escherichia coli mortality
Date:	2018-12
Issue Date:	2019-11-15 15:46:36 (UTC+8)
Publisher:	MDPI
Abstract:	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.
???metadata.dc.relation.uri???:	http://dx.doi.org/10.3390/jcm7120508
Relation:	Journal of Clinical Medicine, v.7, n.12, 508
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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