[Antibiotic Resistance and Risk Factors for Mortality of Blood Stream Infections (BSIs) with Escherichia coli in Patients with Hematological Malignancies]

Abstract

Objective: To analyze the risk factors for mortality of blood stream infections (BSIs) caused by Escherichia coli in the patients with hematological malignancies.

Methods: There were 110 Escherichia coli BSIs patients with hematological malignancies included in recent five years. Among them,77 cases had BSIs caused by extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli (ESBL-EC group),while 33 cases had BSIs with non-ESBL-producing Escherichia coli (non-ESBL-EC group). The antibiotic resistance and clinical features were compared between the two groups,and the risk factors for death within 30 d were analyzed.

Results: Less than 10% of the isolates were resistant to carbapenems and amikacin. Between ESBL-EC group and non-ESBL-EC group,the clinical symptoms,prior use of antibiotics or antifungal agents,risk factors for infection,30 d mortality rates were not significantly different (P>0.05). A logistic regression analysis confirmed that non remission of hematologic malignancies (odds ratio=9.575,95% confidence interval 1.546-59.312,P=0.015) and inappropriate initial antibiotic therapy (odds ratio=8.806,95% confidence interval 1.527-50.772, P=0.015) were independent risk factors for 30 d mortality.

Conclusion: The use of effective antimicrobial treatment as early as possible could reduce the risk of death for hematological malignancies patients suffering Escherichia coli BSIs.

Keywords: Blood streaminfections (BSIs); Escherichia coli; Hematological malignancies.