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Objective   To investigate the prevalence and risk factors of infections caused by Extended-Spectrum  β -Lactamase (ESBL) producing  Escherichia coli  ( E. coli ) in systemic lupus erythematosus (SLE) patients and develop a predictive model.Methods   Three hundred and eighty-four consecutive SLE patients with  E. coli  infection were enrolled in this retrospective case control study from January 2012 to December 2017. Prevalence and antimicrobial susceptibility pattern of ESBL producing  E. coli  were analyzed. Multivariate analysis was performed to determine the risk factors. Sensitivity and specificity were obtained at various point cutoffs and area under the receiver operator characteristic curve (AuROC) was determined to confirm the prediction power of the model.Results   Of the total 384  E. coli  strains tested, 212 (55.2%) produced ESBL. The majority of these isolates were from urine (44.3%). Carbapenems (>80%) and amikacin (89.6%) had good activity against ESBL producing  E. coli . Eleven variables were identified as independent risk factors for ESBL producing  E. coli  infection including Enterobacteriaceae colonization or infection in preceding year (OR=8.15, 95%CI 5.12–21.71), daily prednisone dose > 30mg (OR=5.48, 95%CI 3.12–13.72), low C3 levels (OR=2.17, 95%CI 1.62–6.71), nosocomial acquired infection (OR=4.12, 95%CI 1.98–8.85), etc. The model developed to predict ESBL producing  E. coli  infection was effective, with the AuROC of 0.840 (95% CI 0.799-0.876).Conclusions   The prevalence of ESBL producing  E. coli  was increasing with high antibiotics resistance in patients with SLE. The model revealed excellent predictive performance and exhibited a good discrimination.

biomed research international

Infections Caused by Extended-Spectrum <i>β</i>-Lactamase Producing<i> Escherichia Coli</i> in Systemic Lupus Erythematosus Patients: Prevalence, Risk Factors, and Predictive Model

Infections Caused by Extended-Spectrum β-Lactamase Producing Escherichia Coli in Systemic Lupus Erythematosus Patients: Prevalence, Risk Factors, and Predictive Model