Open AccessAnalysis of early-onset bloodstream infection due to Escherichia coli infection in premature babies
Author(s) -
ILun Chen,
HsinChun Huang,
Chih-Te Wu,
MeiChen OuYang,
MeiIng Chung,
ChihCheng Chen,
JauLing Suen,
ChihHsing Hung
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000007748
Subject(s) - bacteremia , medicine , escherichia coli , mortality rate , hazard ratio , proportional hazards model , microbiology and biotechnology , antibiotics , confidence interval , biology , biochemistry , gene
In early-onset bacteremia among preterm neonates, Escherichia coli ( E. coli ) is the main pathogen and can cause a high mortality rate. Thus, the predictive factors of mortality and extended-spectrum β-lactamase (ESBL)-producing E. coli in preterm babies with E. coli early-onset bacteremia were reported. We retrospectively reviewed preterm neonates who had E. coli bacteremia occurring within 3 days after birth between 2004 and 2015. Maternal and perinatal information were collected from their medical records and analyzed by comparing the survival and nonsurvival groups, and also the ESBL-producing and non-ESBL-producing E. coli bacteremia groups. Mann–Whitney U test, Fisher exact test, and multivariate Cox proportional-hazard model were used for statistical analysis. A total of 27 preterm babies had E. coli bacteremia. The overall mortality rate was 55.56% (15 deaths). Five babies had ESBL-producing E. coli . The low systolic blood pressure of <48 mm Hg and low absolute neutrophil count of <2318 cells/mm 3 were the most significant factors in predicting mortality. Moreover, the level of serum alanine aminotransferase was significantly lower in the ESBL-producing E. coli group than that in the non-ESBL-producing E. coli group. Therefore, the lower systolic blood pressure and absolute neutrophil count were the risk factors of mortality in preterm babies with early-onset E. coli bacteremia, and alanine aminotransferase could be a significant factor in predicting ESBL-producing E. coli .