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Risk factors and microbiological features of recurrent Escherichia coli bloodstream infections

 Yong Chan Kim  ;  Heun Choi  ;  Young Ah Kim  ;  Yoon Soo Park  ;  Young Hee Seo  ;  Hyukmin Lee  ;  Kyungwon Lee 
 PLOS ONE, Vol.18(1) : e0280196, 2023-01 
Journal Title
Issue Date
Anti-Bacterial Agents / pharmacology ; Anti-Bacterial Agents / therapeutic use ; Bacteremia* / microbiology ; Escherichia coli ; Escherichia coli Infections* / microbiology ; Humans ; Risk Factors ; Sepsis* / drug therapy ; Virulence Factors ; beta-Lactamases / genetics
Understanding the risk factors and microbiological features in recurrent Escherichia coli BSI is helpful for clinicians. Data of patients with E. coil BSI from 2017 to 2018 were collected. Antimicrobial resistance rates of E. coli were determined. We also identified the ST131 and ESBL genotype to evaluate the molecular epidemiology of E. coli. Whole genome sequencing was conducted on the available ESBL-producing E. coli samples. Of 808 patients with E. coli BSI, 57 (6.31%) experienced recurrence; 29 developed at 4-30 days after initial BSI (early onset recurrence) and 28 at 31-270 days after initial BSI (late onset recurrence). One hundred forty-nine patients with single episode, whose samples were available for determining the molecular epidemiology, were selected for comparison. Vascular catheterization (adjusted odds ratio [aOR], 4.588; 95% confidence interval [CI], 1.049-20.068), ESBL phenotype (aOR, 2.037; 95% CI, 1.037-3.999) and SOFA score ≥9 (aOR, 3.210; 95% CI, 1.359-7.581) were independent risk factors for recurrence. The proportion of ST131 and ESBL genotype was highest in early onset recurrent BSI (41.4% and 41.4%, respectively), from which E. coil had the highest resistance rates to most antimicrobial agents. Whole genome sequencing on 27 of ESBL-producing E. coli (11 from single episode, 11 from early onset recurrence, and 5 from late onset recurrence) demonstrated that various virulence factors, resistant genes, and plasmid types existed in isolates from all types of BSI. Risk factors contributing to the recurrence and microbiological features of E. coli causing recurrent BSI may be helpful for management planning in the clinical setting.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Yong Chan(김용찬)
Park, Yoon Soo(박윤수)
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Lee, Hyuk Min(이혁민) ORCID logo https://orcid.org/0000-0002-8523-4126
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