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Original Research

Risk factors for infections with extended-spectrum beta-lactamase-producing Escherichia coli in a county of Southern Sweden

, , , &
Pages 93-97 | Published online: 19 Sep 2013
 

Abstract

Background

It is important to identify patients who are at risk for infections with extended-spectrum β-lactamase (ESBL)-producing bacteria in order to reduce mortality, to avoid spread of resistant bacteria in hospitals, and to minimize the number of patients receiving unnecessary treatment with broad-spectrum antibiotics. A case-control survey among Swedish patients was performed at Skåne University Hospital to identify risk factors for developing an infection with ESBL-producing Escherichia coli in a low endemic country.

Methods

We used a computerized database to identify patients with growth of ESBL-producing E. coli (n = 109) in urine or blood cultures and an equal number of controls matched for age and gender with non ESBL-producing E. coli in urine and blood diagnosed between January and October 2008. We used unadjusted P-values.

Results

Patients with ESBL-producing E. coli had a significantly (P < 0.05) higher likelihood of having traveled to Asia including Turkey and the Middle East including Egypt (14/58) than the non-ESBL-positive group (4/53). Hospital stay during the previous year (P < 0.04), especially for more than one month, was another significant (P = 0.01) risk factor for infection with ESBL-producing E. coli (8/58). A stay in the surgical department was a further risk factor (P < 0.01).

Conclusion

In this study, we identified 22 of 58 (38%) patients with ESBL-producing E. coli by considered significant risk factors before starting antibiotics.

Acknowledgments

This research was funded by the Swedish Strategic Programme Against Antibiotic Resistance from Region Skåne, Sweden.

Disclosure

The authors report no conflicts of interest in this work.