Interspecies differences in clinical characteristics and risk factors for third-generation cephalosporin resistance between Escherichia coli and Klebsiella pneumoniae bloodstream infection in patients with liver cirrhosis

Eur J Clin Microbiol Infect Dis. 2022 Dec;41(12):1459-1465. doi: 10.1007/s10096-022-04508-2. Epub 2022 Oct 13.

Abstract

This retrospective study aimed to clarify the interspecies differences in the clinical characteristics and risk factors of bloodstream infection (BSI) due to third-generation cephalosporin-resistant (3GC-R) Escherichia coli (EC) and Klebsiella pneumoniae (KP) in patients with liver cirrhosis (LC). KP BSI had more comorbidities and higher treatment failure rate than EC BSI. Non-alcoholic LC was a risk factor for treatment failure in EC, whereas it was not associated with KP. Risk factors for BSI due to 3GC-R strain were nosocomial infection in EC, and β-lactam/fluoroquinolone treatment ≤ 30 days in KP. These results could help predict outcomes of BSI and improve clinical practice.

Keywords: Bloodstream infection; Enterobacteriaceae; Interspecies difference; Liver cirrhosis; Mortality; Third-generation cephalosporin resistance.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / drug therapy
  • Bacteremia* / epidemiology
  • Bacteremia* / microbiology
  • Cephalosporin Resistance
  • Escherichia coli
  • Escherichia coli Infections* / drug therapy
  • Escherichia coli Infections* / epidemiology
  • Humans
  • Klebsiella Infections* / drug therapy
  • Klebsiella Infections* / epidemiology
  • Klebsiella Infections* / microbiology
  • Klebsiella pneumoniae
  • Liver Cirrhosis / complications
  • Retrospective Studies
  • Risk Factors
  • Sepsis* / drug therapy

Substances

  • Anti-Bacterial Agents