A retrospective study on Escherichia coli bacteremia in immunocompromised patients: Microbiological features, clinical characteristics, and risk factors for shock and death

Autor: Qun Yan, Jun Li, Haichen Wang, Ting Yu, Xiaoyan Tao, Yongmei Hu, Changhang Min, Wen' En Liu, Ming-Xiang Zou, Yi Luo
Jazyk: angličtina
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
Clinical Biochemistry
Bacteremia
medicine.disease_cause
Gastroenterology
Group A
0302 clinical medicine
Risk Factors
Immunology and Allergy
Child
Research Articles
Escherichia coli Infections
Phylogeny
Univariate analysis
Virulence
Mortality rate
Shock
Hematology
Middle Aged
Medical Laboratory Technology
030220 oncology & carcinogenesis
Child
Preschool
outcome
Female
Research Article
Microbiology (medical)
Adult
medicine.medical_specialty
Adolescent
03 medical and health sciences
Immunocompromised Host
Young Adult
Internal medicine
medicine
Escherichia coli
Humans
Risk factor
Aged
Retrospective Studies
business.industry
phylogenetic analysis
Biochemistry (medical)
Public Health
Environmental and Occupational Health
Infant
Retrospective cohort study
medicine.disease
030104 developmental biology
business
Zdroj: Journal of Clinical Laboratory Analysis
ISSN: 1098-2825
0887-8013
Popis: Background To evaluate clinical features, bacterial characteristics, and risk factors for shock and mortality of immunocompromised patients with Escherichia coli bacteremia. Methods A nearly 6‐year retrospective study of E coli bacteremia in 188 immunocompromised patients at Xiangya Hospital was conducted. Demographic, clinical, and laboratory data were documented. Phylogenetic background and virulence factors of E coli isolates were detected by polymerase chain reaction. Risk factors for shock and mortality were also investigated. Results Of all 188 E coli isolates, most prevalent virulence factors were fimH (91.0%), followed by traT (68.6%) and iutA (67.0%), while papG allele I, gafD, and cdtB were not detected. Phylogenetic group D was dominant (42.0%) among all isolates, and group B2 accounted for 17.6%, while group A and B1 accounted for 28.2% and 12.2%, respectively. In univariate analysis, ibeA and cnf1 were associated with mortality, which were not found in multivariate regression analysis. 22.3% of patients suffered shock, and 30‐day mortality rate was 21.3%. MDR (HR 2.956; 95% CI, 1.091‐8.012) was the only risk factor for shock, while adult (HR 0.239; 95% CI, 0.108‐0.527) was a protective factor. Multivariate analysis revealed that shock (HR 4.268; 95% CI, 2.208‐8.248; P 2 (HR 2.073; 95% CI, 1.087‐3.952; P = .027) were associated with fatal outcome. Conclusions Escherichia coli bacteremia was highly lethal in immunocompromised patients, and host‐related factors played major roles in poor prognosis, while bacterial determinants had little effect on outcome. This study also provided additional information about the virulence and phylogenetic group characteristics of E coli bacteremia.
Databáze: OpenAIRE
Externí odkaz: