Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Jul-Aug;6(6):344-9.
doi: 10.1002/jhm.877.

The clinical impact of fluoroquinolone resistance in patients with E coli bacteremia

Bernard C Camins  1 , Jonas Marschall, Shannon R DeVader, Dawn E Maker, Matthew W Hoffman, Victoria J Fraser
Affiliations

The clinical impact of fluoroquinolone resistance in patients with E coli bacteremia

Bernard C Camins et al. J Hosp Med. 2011 Jul-Aug.

Abstract

Background: There are limited data on fluoroquinolone resistance and its impact on mortality in cases of Escherichia coli bloodstream infection (BSI).

Objective: To determine risk factors for in-hospital mortality among patients with E coli BSIs.

Design: A retrospective case-control study.

Setting: A 1250-bed tertiary academic medical center.

Patients: Patients with fluoroquinolone-resistant E coli BSI from January 1, 2000 through December 31, 2005 with 1:1 matched control patients with fluoroquinolone-sensitive E coli BSI. INDEPENDENT OUTCOME: In-hospital mortality.

Results: A total of 93 cases and 93 control patients were included. Compared with control patients, cases were more likely to be admitted from a long-term care facility (35% vs. 9%; P < .001) and to have a hospital-acquired bacteremia (54% vs. 33%; P = .008). Crude mortality was 26% for cases and 8% for controls (P = .002). On univariate analysis, predictors for in-hospital mortality included female gender, admission from a long-term care facility, APACHE II score >10, Charlson comorbidity score >4, cardiac dysfunction, cirrhosis, renal dysfunction, treatment with corticosteroids, and a fluoroquinolone-resistant E coli bacteremia. On multivariate analysis, independent risk factors for in-hospital mortality were cirrhosis (adjusted odds ratio [aOR], 7.2; confidence interval [CI], 1.7-29.8; P = .007), cardiac dysfunction (aOR, 3.9; CI, 1.6-9.4; P = .003), and infection with a fluoroquinolone-resistant E coli isolate (aOR, 3.9; CI, 1.5-10.2; P = .005).

Conclusions: After controlling for severity of illness and multiple comorbidities only fluoroquinolone resistance, cirrhosis, and cardiac dysfunction independently predicted mortality in patients with E coli bacteremia.

PubMed Disclaimer

Conflict of interest statement

All authors have no relevant conflict of interest to disclose.

References

    1. Gaynes R, Edwards JR. Overview of nosocomial infections caused by gram-negative bacilli. Clin Infect Dis. 2005 Sep 15;41(6):848–854. - PubMed
    1. Diekema DJ, Pfaller MA, Jones RN, et al. Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis. 1999 Sep;29(3):595–607. - PubMed
    1. Kern WV, Andriof E, Oethinger M, Kern P, Hacker J, Marre R. Emergence of fluoroquinolone-resistant Escherichia coli at a cancer center. Antimicrob Agents Chemother. 1994 Apr;38(4):681–687. - PMC - PubMed
    1. Carratala J, Fernandez-Sevilla A, Tubau F, Callis M, Gudiol F. Emergence of quinolone-resistant Escherichia coli bacteremia in neutropenic patients with cancer who have received prophylactic norfloxacin. Clin Infect Dis. 1995 Mar;20(3):557–560. discussion 561–553. - PubMed
    1. Oteo J, Lazaro E, de Abajo FJ, Baquero F, Campos J. Antimicrobial-resistant invasive Escherichia coli, Spain. Emerg Infect Dis. 2005 Apr;11(4):546–553. - PMC - PubMed

Publication types

Substances