부산대학교 도서관

Introduction: Escherichia coli (EC) is one of the most common bloodstream infections and carries a significant mortality rate. International studies have shown that age, antibiotic resistance and choice of empirical antibiotics affect the prognosis of patients with EC bacteremia. However, there is scarce local data to evaluate on the prognostic factors for EC bacteremia in Hong Kong. Our study aimed to evaluate the clinical predictors and outcomes of EC bacteremia in critically ill patients admitted to Intensive Care Unit (ICU) in a regional hospital in Hong Kong. Methods: The study is a retrospective analysis of patients with EC bacteremia admitted to the Department of ICU of Pamela Youde Nethersole Eastern Hospital (PYNEH), from 1/1/2009 to 30/12/2017 (8 years). Patients' demographics, past medical histories, clinical parameters, microbiological data, drug prescriptions, and supportive treatments were analyzed. Results: Among 380 patients, 30-day non-survivors were older (p=0.016), more likely to present with respiratory sepsis (p 0.001) and require renal replacement therapy and mechanical ventilation during ICU stay (p 100 (HR=6.129; 95% CI=3.271-11.485; p=0.001), respiratory sepsis (HR=4.366; 95% CI=2.147- 8.878; p=1.3 (HR=3.007; 95% CI=1.685-5.365; p=70 (HR=2.999; 95% CI=1.597-5.632; p=0.001), liver cirrhosis (HR=2.632, CI=1.051-6.591, p=0.039), albumin 24g/L (HR=2.291; 95% CI=1.229-4.270; p=0.009) and interventional radiological (IR) procedures or operative interventions (HR=0.358; 95% CI=0.188-0.679; p=0.002) were independent risk factors for 30-day mortality. Conclusion: Disease severity, respiratory sepsis, use of steroid, age and liver cirrhosis are important predictors for 30-day mortality in critically ill patients with EC bacteremia, while IR procedures or operative interventions is associated with lower 30-day mortality.