Association between dementia and reduced walking ability and 30-day mortality in patients with extended-spectrum beta-lactamase-producing Escherichia coli bacteremia

Eur J Clin Microbiol Infect Dis. 2017 Dec;36(12):2417-2422. doi: 10.1007/s10096-017-3077-6. Epub 2017 Aug 12.

Abstract

Previous studies have shown controversial results of factors associated with short-term mortality in patients with extended-spectrum beta-lactamase (ESBL)-producing E. coli bacteremia and no research has investigated the impact of the geriatric assessment criteria on short-term mortality. Our objective was to determine whether dementia and walking ability are associated with 30-day mortality in patients with ESBL-producing E. coli bacteremia. All blood bottle cultures, analyzed from January 2008 to April 2015, in the Bacteriology Department of a 2,600-bed, university-affiliated center, Nantes, France, were retrospectively extracted. Factors associated with short-term mortality in patients with ESBL-producing E. coli bacteremia: 140 patients with an ESBL-producing E. coli bloodstream infection were included; 22 (15.7%) patients died within 30 days following the first positive blood bottle culture of ESBL-producing E.coli. In multivariate analysis, a reduced ability to walk (OR = 0.30; p = 0.021), presence of dementia (OR = 54.51; p = 0.040), a high Sepsis-related Organ Failure Assessment (SOFA) score (OR = 1.69; p < 0.001), presence of neutropenia (OR = 12.94; p = 0.049), and presence of a urinary tract infection (OR = 0.07; p = 0.036), were associated with 30-day mortality. Our findings provide new data showing an independent association between 30-day mortality with dementia and reduced walking ability, in patients with ESBL-producing E. coli bacteremia. These criteria should be considered in the therapeutic management of patients with ESBL-producing E. coli bacteremia.

Keywords: Dementia; E. coli; ESBL; Mortality; Walking status.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia*
  • Dementia / epidemiology*
  • Dementia / etiology*
  • Escherichia coli Infections / complications*
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Escherichia coli* / genetics
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Disorders / epidemiology*
  • Motor Disorders / etiology*
  • Odds Ratio
  • Retrospective Studies
  • Risk Factors
  • beta-Lactamases / genetics

Substances

  • beta-Lactamases