دورية أكاديمية

Clinical presentation and antimicrobial resistance of invasive Escherichia coli disease in hospitalized older adults: a prospective multinational observational study.

التفاصيل البيبلوغرافية
العنوان: Clinical presentation and antimicrobial resistance of invasive Escherichia coli disease in hospitalized older adults: a prospective multinational observational study.
المؤلفون: Doua, Joachim, Rodríguez-Baño, Jesús, Froget, Rachel, Puranam, Padma, Go, Oscar, Geurtsen, Jeroen, van Rooij, Sanne, Vilken, Tuba, Minoru, Inage, Yasumori, Izumi, Spiessens, Bart, Tacconelli, Evelina, Biehl, Lena M., Thaden, Joshua T., Sarnecki, Michal, Goossens, Herman, Poolman, Jan, Bonten, Marc, Ekkelenkamp, Miquel, Violette, Madison
المصدر: Infection; Jun2024, Vol. 52 Issue 3, p1073-1085, 13p
مصطلحات موضوعية: ANTIBIOTICS, DRUG resistance in microorganisms, SCIENTIFIC observation, SYSTEMIC inflammatory response syndrome, BACTEREMIA, LONGITUDINAL method, ESCHERICHIA coli diseases, RESEARCH, SEPSIS, HOSPITAL care of older people, KIDNEY diseases
مستخلص: Background: Clinical data characterizing invasive Escherichia coli disease (IED) are limited. We assessed the clinical presentation of IED and antimicrobial resistance (AMR) patterns of causative E. coli isolates in older adults. Methods: EXPECT-2 (NCT04117113) was a prospective, observational, multinational, hospital-based study conducted in patients with IED aged ≥ 60 years. IED was determined by the microbiological confirmation of E. coli from blood; or by the microbiological confirmation of E. coli from urine or an otherwise sterile body site in the presence of requisite criteria of systemic inflammatory response syndrome (SIRS), Sequential Organ Failure Assessment (SOFA), or quick SOFA (qSOFA). The primary outcomes were the clinical presentation of IED and AMR rates of E. coli isolates to clinically relevant antibiotics. Complications and in-hospital mortality were assessed through 28 days following IED diagnosis. Results: Of 240 enrolled patients, 80.4% had bacteremic and 19.6% had non-bacteremic IED. One-half of infections (50.4%) were community-acquired. The most common source of infection was the urinary tract (62.9%). Of 240 patients, 65.8% fulfilled ≥ 2 SIRS criteria, and 60.4% had a total SOFA score of ≥ 2. Investigator-diagnosed sepsis and septic shock were reported in 72.1% and 10.0% of patients, respectively. The most common complication was kidney dysfunction (12.9%). The overall in-hospital mortality was 4.6%. Of 299 E. coli isolates tested, the resistance rates were: 30.4% for trimethoprim-sulfamethoxazole, 24.1% for ciprofloxacin, 22.1% for levofloxacin, 16.4% for ceftriaxone, 5.7% for cefepime, and 4.3% for ceftazidime. Conclusions: The clinical profile of identified IED cases was characterized by high rates of sepsis. IED was associated with high rates of AMR to clinically relevant antibiotics. The identification of IED can be optimized by using a combination of clinical criteria (SIRS, SOFA, or qSOFA) and culture results. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:03008126
DOI:10.1007/s15010-023-02163-z