Where are we going? Analysis of MDR and ESBL E. coli monobacteremia in ICU of university hospital : [atspausdintas pranešimas žurnale] / D Adukauskiene, D Valanciene, A Dambrauskiene

no. P408

Introduction: The aim of study was to analyze multidrug-resistant (MDR) and ex-tended spectrum beta –lactamases (ESBL) producing E. coli strainsof monobacteremia also associated factors with length of stay inIntensive Care Unit (ICU) > =7 days and mortality. MethodsThe retrospective data analysis of patients (pts) treated in surgicaland medical ICU of Kaunas Clinics with E. coli positive blood cultureduring 2005-2015 was carried out.ResultsThere were found 87 (70.7%) MDR strains among 123 cases of E. colimonobacteremia (P = 0.046). Rate of MDR strains during study periodwas: 6 (42.9%) cases in 2005, 12 (66.7%) in 2010, 12 (85.7%) in 2015(P = 0.027, RR = 17.324).There were found 57/87 (65.5%) cases of ESBL producing strainsamong E. coli MDR strains (P = 0.04). Rate of ESBL producers duringstudy period was: 2 (16.7%) cases in 2005, 7 (58.3%) in 2010, 10(76.0%) in 2015 (P = 0.03, RR = 14.856).28/57 (49.1%) pts with both MDR and ESBL E. coli strain stayed inICU > =7 days. All 28 (100%) pts had SOFA score > =13, weremechanically ventilated > =3 days and were in shock, respectively (P= 0.001), 25/28 (89.3%) were admitted from emergency department(P = 0.03).79/87 (90.8%) pts with E. coli MDR strain have died. All 79 (100%) ptswere mechanically ventilated (P = 0.04), 78 (98.7%) were in shock (P= 0.001, OR = 5.909, CI95% = 2.176–16.049), 68 (81.0%) had diabetesmellitus (P = 0.03), 66 (78.6%) had renal dysfunction (P = 0.046), 59(70.2%) had SOFA score > =13 (P = 0.032, RR = 12.00) and 54 (65.5%)pts had ESBL strain (P = 0.04).54/57 (94.7%) pts with ESBL producing E. coli strain have died. Allthese 54 (100%) pts were mechanically ventilated (P = 0.001), were inshock (P = 0.001), 50 (92.6%) had SOFA score > =13 (P = 0.01), 45(83.3%) had diabetes mellitus (P = 0.02) and 35 (64.8%) pts had renaldysfunction (P = 0.04).Conclusions.[...].