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Yeungnam Univ J Med > Volume 30(2); 2013 > Article
Yeungnam University Journal of Medicine 2013;30(2):83-89.
DOI:    Published online December 31, 2013.
Risk Factors of Nosocomial Bacteremia of Extended-spectrum beta-Lactamase Producing Escherichia coli.
Daisik Ko, Song Mi Moon, Ji Sung Lee, Yoon Soo Park, Yong Kyun Cho
1Gachon University School of Medicine, Incheon, Korea.
2Department of Internal Medicine, Gachon University School of Medicine, Gil Medical Center, Incheon, Korea.,
3Department of Obstetrics and Gynecology, Gachon University School of Medicine, Gil Medical Center, Incheon, Korea.
BACKGROUND: The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is increasing rapidly worldwide. Treatment options for ESBL-producing E. coli are limited, and infections caused by this organism are associated with improper antibiotic use, a long hospital stay, and increased mortality. Thus, the assessment and early recognition of the risk factors of nosocomial infections due to ESBL-producing E. coli are important for the infection control and proper treatment. METHODS: A case-control study was performed that included nosocomial episodes of ESBL-producing E. coli bacteremia at a tertiary care hospital from January 2004 to December 2007. For each case patient, three controls were randomly selected and data on predisposing factors were collected. RESULTS: Fifty-five cases of nosocomial ESBL-producing E. coli bacteremia were studied. Carbapenem usage (OR: 11.3, 95% CI: 1.1-115.9, p=0.041), quinolone usage (OR: 4.5, 95% CI: 1.1-18.8, p=0.042), biliary obstructive disease (OR: 11.8, 95% CI: 3.0-46.7, p<0.001) and the APACHE II score (OR: 1.3, 95% CI: 1.2- 1.5, p<0.001) were analyzed as independent risk factors of nosocomial ESBL-producing E. coli bacteremia. CONCLUSION: Our results showed that physicians caring for patients with risk factors of nosocomial bacteremia should consider ESBL-producing E. coli as the causative organisms of the disease.
Key Words: Extended-spectrum beta-lactamase, Escherichia coli, Nosocomial, Bacteremia


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