In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections
There has been a progressive rise in the incidence of blood stream infections (BSI) caused by multidrug-resistant Gram-negative organisms (MDR GN), which cause increased morbidity and mortality. For this reason, recent studies have focused on risk factors of acquisition of carbapenemase-producing En...
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doaj-ed910d9070ec4242bae9cb0142cd978a2020-11-24T23:42:44ZengMDPI AGDiseases2079-97212018-08-01637110.3390/diseases6030071diseases6030071In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream InfectionsRuchir Chavada0Deborah Tong1Michael Maley2Department of Microbiology and Infectious Diseases, NSW Health Pathology -Central Coast, Gosford, NSW 2250, AustraliaPharmacy Department, Central Coast Local Health District, Gosford, NSW 2250, AustraliaDepartment of Microbiology and Infectious Diseases, NSW Health Pathology-South West Sydney, Sydney, NSW 2170, AustraliaThere has been a progressive rise in the incidence of blood stream infections (BSI) caused by multidrug-resistant Gram-negative organisms (MDR GN), which cause increased morbidity and mortality. For this reason, recent studies have focused on risk factors of acquisition of carbapenemase-producing Enterobacteriaceae and extended-spectrum beta-lactamase producers. However, there is limited data on risk factors for BSI caused by AmpC-producing Enterobacteriaceae (AmpC EC), especially in low prevalence settings such as Australia. This study was performed to identify risk factors for acquisition of AmpC E. coli, using a retrospective matched case control design over a 3-year period. Patients with BSI caused by AmpC E. coli were matched with controls (third generation cephalosporin susceptible E. coli) by age and site of infection (n = 21). There was no significant difference in age, sex, clinical outcome, time to onset of BSI, recent antibiotic use (last 3 months), comorbidities (type 2 diabetes mellitus, renal failure) intensive care unit admission, underlying hematological condition, immunosuppressant use, APACHE II score, or any recent urological procedures (within last 3 months) between the two groups. On univariate analysis, the AmpC E. coli group were more likely to have had a surgical procedure in hospital and lived in a residential aged care facility. On multivariate logistic regression analysis, a recent surgical procedure was associated with the onset of AmpC E. coli BSI (Odd’s Ratio (OR) 4.78, p = 0.034). We concluded that in a relatively low prevalence setting such as Australia, AmpC E. coli BSI is potentially associated with surgery performed in hospital due to previous antibiotic exposure and longer hospitalization.http://www.mdpi.com/2079-9721/6/3/71AmpCrisk factorssurgeryblaCMYblood stream infections |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ruchir Chavada Deborah Tong Michael Maley |
spellingShingle |
Ruchir Chavada Deborah Tong Michael Maley In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections Diseases AmpC risk factors surgery blaCMY blood stream infections |
author_facet |
Ruchir Chavada Deborah Tong Michael Maley |
author_sort |
Ruchir Chavada |
title |
In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections |
title_short |
In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections |
title_full |
In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections |
title_fullStr |
In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections |
title_full_unstemmed |
In-Hospital Surgery as a Risk Factor for Onset of AmpC-Producing Escherichia coli Blood Stream Infections |
title_sort |
in-hospital surgery as a risk factor for onset of ampc-producing escherichia coli blood stream infections |
publisher |
MDPI AG |
series |
Diseases |
issn |
2079-9721 |
publishDate |
2018-08-01 |
description |
There has been a progressive rise in the incidence of blood stream infections (BSI) caused by multidrug-resistant Gram-negative organisms (MDR GN), which cause increased morbidity and mortality. For this reason, recent studies have focused on risk factors of acquisition of carbapenemase-producing Enterobacteriaceae and extended-spectrum beta-lactamase producers. However, there is limited data on risk factors for BSI caused by AmpC-producing Enterobacteriaceae (AmpC EC), especially in low prevalence settings such as Australia. This study was performed to identify risk factors for acquisition of AmpC E. coli, using a retrospective matched case control design over a 3-year period. Patients with BSI caused by AmpC E. coli were matched with controls (third generation cephalosporin susceptible E. coli) by age and site of infection (n = 21). There was no significant difference in age, sex, clinical outcome, time to onset of BSI, recent antibiotic use (last 3 months), comorbidities (type 2 diabetes mellitus, renal failure) intensive care unit admission, underlying hematological condition, immunosuppressant use, APACHE II score, or any recent urological procedures (within last 3 months) between the two groups. On univariate analysis, the AmpC E. coli group were more likely to have had a surgical procedure in hospital and lived in a residential aged care facility. On multivariate logistic regression analysis, a recent surgical procedure was associated with the onset of AmpC E. coli BSI (Odd’s Ratio (OR) 4.78, p = 0.034). We concluded that in a relatively low prevalence setting such as Australia, AmpC E. coli BSI is potentially associated with surgery performed in hospital due to previous antibiotic exposure and longer hospitalization. |
topic |
AmpC risk factors surgery blaCMY blood stream infections |
url |
http://www.mdpi.com/2079-9721/6/3/71 |
work_keys_str_mv |
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