ArticleBMC infectious diseases2019
Prevalence of and risk factor for community-onset third-generation cephalosporin-resistant Escherichia coli bacteremia at a medical center in Taiwan.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 36 citations in OpenAlex.
- Etiology of bloodstream infections in adult diabetic patients from a single tertiary hospital in southern Vietnam: a retrospective study.Tropical medicine and health · 2026Article
- Development and Validation of an Interpretable Machine Learning Model for Predicting Thrombocythemia Risk During Third Generation Cephalosporin Therapy.Journal of blood medicine · 2026Article
- Human vaginal Lactobacillus Jensenii -derived (-)-Terpinen-4-ol restores antibiotic sensitivity by inhibiting efflux pumps in drug resistant E. coli and K. pneumoniae.Scientific reports · 2025Article
- Evaluation of Emerging Antimicrobials Resistance in Nosocomial Infections Caused byInterdisciplinary perspectives on infectious diseases · 2025Article
- From Epidemiology of Community-Onset Bloodstream Infections to the Development of Empirical Antimicrobial Treatment-Decision Algorithm in a Region with High Burden of Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2023Article
- Diagnostic Accuracy of Hospital Antibiograms in Predicting the Risk of Antimicrobial Resistance in Enterobacteriaceae Isolates: A Nationwide Multicenter Evaluation at the Veterans Health Administration.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Risk factors in acquiring multidrug-resistant Klebsiella pneumoniae infections in a hospital setting in Saudi Arabia.Scientific reports · 2023Article
- Phenotypic and genotypic antibiotic susceptibility profiles of Gram-negative bacteria isolated from bloodstream infections at a referral hospital, Lusaka, Zambia.PLOS global public health · 2023Article
- Risk for primary cephalosporin resistance in Gram-negative bacteremia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- The Resistance Mechanisms and Clinical Impact of Resistance to the Third Generation Cephalosporins in Species ofAntibiotics (Basel, Switzerland) · 2022Article
- From Pathophysiological Hypotheses to Case-Control Study Design: Resistance from Antibiotic Exposure in Community-Onset Infections.Antibiotics (Basel, Switzerland) · 2022Article
- Antibiotic resistance and siderophores production by clinicalBiotechnologia · 2022Article
- Impact of Prior Antibiotic Use in Primary Care onAntibiotics (Basel, Switzerland) · 2021Article
- Clinical Characteristics of Patients and Whole Genome Sequencing-Based Surveillance ofFrontiers in microbiology · 2021Article
- Clinical Impact and Risk Factors of Nonsusceptibility to Third-Generation Cephalosporins Among Hospitalized Adults with MonomicrobialInfection and drug resistance · 2021Article
- National Surveillance of Antimicrobial Susceptibility of Bacteremic Gram-Negative Bacteria with Emphasis on Community-Acquired Resistant Isolates: Report from the 2019 Surveillance of Multicenter Antimicrobial Resistance in Taiwan (SMART).Antimicrobial agents and chemotherapy · 2020Article
- Trends in Antimicrobial Susceptibility ofAntibiotics (Basel, Switzerland) · 2020Article
- Clinical Utilization of Blood and Urine Cultures and Incidences of Bacteremia and Bacteriuria in a Hospital in Thailand.Medical science monitor basic research · 2020Article
- Colonization With Multidrug-Resistant Organisms Among Healthy Adults in the Community Setting: Prevalence, Risk Factors, and Composition of Gut Microbiome.Frontiers in microbiology · 2020Article
- Antimicrobial resistance of bacteraemia in the emergency department of a German university hospital (2013-2018): potential carbapenem-sparing empiric treatment options in light of the new EUCAST recommendations.BMC infectious diseases · 2019Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreased resistance to third-generation cephalosporin (3GC) is a serious concern for community-onset Escherichia coli infection because this resistance easily delays effective treatment. This study surveyed the current antimicrobial resistance pattern among E. coli isolates that cause community-onset bacteremia, with a special focus on the prevalence of and the risk factors for 3GC resistance, and determined factors for poor outcomes among patients with community-onset E. coli bacteremia.
methodsThis retrospective study was conducted at a tertiary-care teaching hospital in Taiwan. All adult patients with community-onset E. coli bacteremia between January 1, 2015, and December 31, 2015 were enrolled and were divided into two groups depending on whether the E. coli isolate was susceptible to 3GCs. Risk factors for 3GC resistance, 14-day all-cause mortality, and length of hospital stay were analyzed.
resultsThe overall rate of 3GC resistance among E. coli isolates causing community-onset bacteremia was 19.7%, whereas it was 9.6% if only isolates causing community-acquired bacteremia were considered. Independent risk factors for 3GC-resistant community-onset E. coli bacteremia were hospitalization within the past 1 year (odds ratio: 2.4, 95% confidence interval: 1.6-3.7, P < 0.001), exposure to antibiotics within the past 15 days (2.6, 1.4-4.9, P = 0.002), residence in nursing home or long-term care facility (3.6, 1.0-12.3, P = 0.044), presence of underlying genitourinary disease (1.9, 1.2-2.9, P = 0.005), and presence of indwelling implantable intravenous port (2.2, 1.1-4.1, P = 0.021). 3GC resistance was independently associated with increased length of hospital stays (P < 0.001).
conclusionIn this study, the prevalence of 3GC resistance was high among both patients with community-onset and those with community-acquired E. coli bacteremia. 3GC resistance is a strong independent risk factor for length of hospital stay. The effectiveness of empirical antibiotic treatment would partially explain the impact of 3GC resistance, but more evidence is needed. The choice of appropriate empirical antibiotics for community-onset E. coli bacteremia might impact outcomes in terms of the length of hospital stay and need to be individualized according to the patient-specific risk for acquiring drug-resistant pathogens.
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