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. 2024 Feb 9:17:543-550.
doi: 10.2147/IDR.S449731. eCollection 2024.

Incidence of and Risk Factors for Third-Generation Cephalosporin-Resistant Escherichia coli Bloodstream Infections in Children

Jie Cheng  1 , Ya Liu  2 , Shaojun Li  1 , Kaibin Pu  1 , Lin Yang  1 , Liping Tan  1
Affiliations

Incidence of and Risk Factors for Third-Generation Cephalosporin-Resistant Escherichia coli Bloodstream Infections in Children

Jie Cheng et al. Infect Drug Resist. .

Abstract

Objective: Third-generation cephalosporin-resistant (3GC-R) bloodstream infection (BSI) is associated with poor prognosis. We investigated the incidence of and risk factors for 3GC-R Escherichia coli (E. coli) BSI in children.

Methods: Patients with E. coli BSIs who were hospitalized at the Children's Hospital of Chongqing Medical University were retrospectively enrolled. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for 3GC-R BSI.

Results: Two hundred fifty-two children with E. coli BSIs were enrolled. The mortality rate was 11.51% (29/252). The infection rate of 3GC-R E. coli was 48.81% (123/252), and the incidence of E. coli BSI during hospitalization was 18.58 per 1000 person-days. Approximately half (47.22%, 119/252) of the children were infected with extended-spectrum beta-lactamases (ESBLs) produced by E. coli. More than one-third (37.30%, 94/252) of the children were unnecessarily administrated carbapenems. According to our logistic regression analysis, a history of carbapenem administration, an elevated Pediatric Sequential Organ Failure Assessment (pSOFA) score ≥2, and antimicrobial agent administration before blood culture were independently associated with 3GC-R BSI (odds ratio [OR] 2.05, 95% confidence interval [CI] 1.08-3.94, P=0.029; OR 2.00, 95% CI 1.10-3.71, P=0.025, OR 1.86, 95% CI 1.02-3.42, P=0.044, respectively).

Conclusion: In this study, the incidence of 3GC-R E. coli BSI among children was retrospectively evaluated. Patients with a history of carbapenem administration, an elevated pSOFA score ≥2 and who were administrated antimicrobial agents before blood culture had an increased risk of 3GC-R E. coli BSI.

Keywords: Escherichia coli; bloodstream infection; children; inappropriate use of carbapenems; third-generation cephalosporin-resistant.

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Conflict of interest statement

The authors have no competing interests to declare for this work.

Figures

Figure 1
Figure 1
Distribution of pathogens isolated from blood cultures.
Figure 2
Figure 2
Flowchart of the study population selection process.
See this image and copyright information in PMC

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