Discovery - University of Dundee - Online Publications

Library & Learning Centre

Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins

Burden of antimicrobial resistance in European hospitals: excess mortality and length of hospital stay associated with bloodstream infections due to Escherichia coli resistant to third-generation cephalosporins

Research output: Contribution to journalArticle

View graph of relations

Authors

  • M. E. A. de Kraker
  • M. Wolkewitz
  • P. G. Davey
  • W. Koller
  • J. Berger
  • J. Nagler
  • C. Icket
  • S. Kalenic
  • J. Horvatic
  • H. Seifert
  • A. Kaasch
  • O. Paniara
  • A. Argyropoulou
  • M. Bompola
  • E. Smyth
  • M. Skally
  • A. Raglio
  • U. Dumpis
  • A. Melbarde Kelmere
  • M. Borg
  • And 8 others
  • D. Xuereb
  • M. C. Ghita
  • M. Noble
  • J. Kolman
  • S. Grabljevec
  • D. Turner
  • L. Lansbury
  • H. Grundmann

Research units

Info

Original languageEnglish
Pages398-407
Number of pages10
JournalJournal of Antimicrobial Chemotherapy
Journal publication dateFeb 2011
Journal number2
Volume66
DOIs
StatePublished

Abstract

This study determined excess mortality and length of hospital stay (LOS) attributable to bloodstream infection (BSI) caused by third-generation-cephalosporin-resistant Escherichia coli in Europe.

A prospective parallel matched cohort design was used. Cohort I consisted of patients with third-generation-cephalosporin-resistant E. coli BSI (REC) and cohort II consisted of patients with third-generation-cephalosporin-susceptible E. coli BSI (SEC). Patients in both cohorts were matched for LOS before infection with patients free of the respective BSI. Thirteen European tertiary care centres participated between July 2007 and June 2008.

Cohort I consisted of 111 REC patients and 204 controls and cohort II consisted of 1110 SEC patients and 2084 controls. REC patients had a higher mortality at 30 days (adjusted odds ratio = 4.6) and a higher hospital mortality (adjusted hazard ratio = 5.7) than their controls. LOS was increased by 8 days. For SEC patients, these figures were adjusted odds ratio = 1.9, adjusted hazard ratio = 2.0 and excess LOS = 3 days. A 2.5 times [95% confidence interval (95% CI) 0.9-6.8] increase in all-cause mortality at 30 days and a 2.9 times (95% CI 1.2-6.9) increase in mortality during entire hospital stay as well as an excess LOS of 5 days (95% CI 0.4-10.2) could be attributed to resistance to third-generation cephalosporins in E. coli BSI.

Morbidity and mortality attributable to third-generation-cephalosporin-resistant E. coli BSI is significant. If prevailing resistance trends continue, high societal and economic costs can be expected. Better management of infections caused by resistant E. coli is becoming essential.

Documents

Library & Learning Centre

Contact | Accessibility | Policy