Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia

Nam Su Ku, Yong Chan Kim, Min Hyung Kim, Je Eun Song, Dong Hyun Oh, Jin Young Ahn, Sun Bean Kim, Hye won Kim, Su Jin Jeong, Sang Hoon Han, Chang Oh Kim, Young Goo Song, June Myung Kim, JunYong Choi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Gram-negative bacteremia is common in elderly patients and, compared with younger patients, mortality rates in bacteremic elderly patients are high. ESBL-producing organisms were one of the most important risk factors associated with mortality. In addition, older age is one of risk factors for colonization or infection with ESBL-producing organisms. We conducted a retrospective cohort study to evaluate risk factors of all-cause 28-day mortality in elderly patients with ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacteremia. Patients aged 65 years or older, who had one or more blood cultures positive for E. coli and K. pneumoniae and who were hospitalized between January 2006 and December 2010 at a tertiary-care teaching hospital, were included. 191 bacteremic elderly patients were eligible for the study. The all-cause 28-day mortality rate was 24.6% (47/191). In multivariate analysis, prior antimicrobial therapy (p= 0.014) and an elevated SOFA score (p< 0.001) were independent risk factors for increased mortality, while urinary tract infection (UTI) was an independent determinant for non-mortality (p= 0.011). In the current study, prior antimicrobial therapy within 30 days, an elevated SOFA score and nonurinary source of infection were significantly associated with adverse outcomes in elderly patients with ESBL-producing gram-negative bacteremia.

Original languageEnglish
Pages (from-to)105-109
Number of pages5
JournalArchives of Gerontology and Geriatrics
Volume58
Issue number1
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Klebsiella pneumoniae
Bacteremia
mortality
Escherichia coli
Mortality
cause
colonization
multivariate analysis
Tertiary Healthcare
Infection
determinants
Urinary Tract Infections
Teaching Hospitals
Cohort Studies
Multivariate Analysis
Retrospective Studies
Teaching
Therapeutics

All Science Journal Classification (ASJC) codes

  • Health(social science)
  • Ageing
  • Gerontology
  • Geriatrics and Gerontology

Cite this

Ku, Nam Su ; Kim, Yong Chan ; Kim, Min Hyung ; Song, Je Eun ; Oh, Dong Hyun ; Ahn, Jin Young ; Kim, Sun Bean ; Kim, Hye won ; Jeong, Su Jin ; Han, Sang Hoon ; Kim, Chang Oh ; Song, Young Goo ; Kim, June Myung ; Choi, JunYong. / Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia. In: Archives of Gerontology and Geriatrics. 2014 ; Vol. 58, No. 1. pp. 105-109.
@article{99c83e9e5eb9497091e7c618c9fc7107,
title = "Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia",
abstract = "Gram-negative bacteremia is common in elderly patients and, compared with younger patients, mortality rates in bacteremic elderly patients are high. ESBL-producing organisms were one of the most important risk factors associated with mortality. In addition, older age is one of risk factors for colonization or infection with ESBL-producing organisms. We conducted a retrospective cohort study to evaluate risk factors of all-cause 28-day mortality in elderly patients with ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacteremia. Patients aged 65 years or older, who had one or more blood cultures positive for E. coli and K. pneumoniae and who were hospitalized between January 2006 and December 2010 at a tertiary-care teaching hospital, were included. 191 bacteremic elderly patients were eligible for the study. The all-cause 28-day mortality rate was 24.6{\%} (47/191). In multivariate analysis, prior antimicrobial therapy (p= 0.014) and an elevated SOFA score (p< 0.001) were independent risk factors for increased mortality, while urinary tract infection (UTI) was an independent determinant for non-mortality (p= 0.011). In the current study, prior antimicrobial therapy within 30 days, an elevated SOFA score and nonurinary source of infection were significantly associated with adverse outcomes in elderly patients with ESBL-producing gram-negative bacteremia.",
author = "Ku, {Nam Su} and Kim, {Yong Chan} and Kim, {Min Hyung} and Song, {Je Eun} and Oh, {Dong Hyun} and Ahn, {Jin Young} and Kim, {Sun Bean} and Kim, {Hye won} and Jeong, {Su Jin} and Han, {Sang Hoon} and Kim, {Chang Oh} and Song, {Young Goo} and Kim, {June Myung} and JunYong Choi",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.archger.2013.07.002",
language = "English",
volume = "58",
pages = "105--109",
journal = "Archives of Gerontology and Geriatrics",
issn = "0167-4943",
publisher = "Elsevier Ireland Ltd",
number = "1",

}

Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia. / Ku, Nam Su; Kim, Yong Chan; Kim, Min Hyung; Song, Je Eun; Oh, Dong Hyun; Ahn, Jin Young; Kim, Sun Bean; Kim, Hye won; Jeong, Su Jin; Han, Sang Hoon; Kim, Chang Oh; Song, Young Goo; Kim, June Myung; Choi, JunYong.

In: Archives of Gerontology and Geriatrics, Vol. 58, No. 1, 01.01.2014, p. 105-109.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia

AU - Ku, Nam Su

AU - Kim, Yong Chan

AU - Kim, Min Hyung

AU - Song, Je Eun

AU - Oh, Dong Hyun

AU - Ahn, Jin Young

AU - Kim, Sun Bean

AU - Kim, Hye won

AU - Jeong, Su Jin

AU - Han, Sang Hoon

AU - Kim, Chang Oh

AU - Song, Young Goo

AU - Kim, June Myung

AU - Choi, JunYong

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Gram-negative bacteremia is common in elderly patients and, compared with younger patients, mortality rates in bacteremic elderly patients are high. ESBL-producing organisms were one of the most important risk factors associated with mortality. In addition, older age is one of risk factors for colonization or infection with ESBL-producing organisms. We conducted a retrospective cohort study to evaluate risk factors of all-cause 28-day mortality in elderly patients with ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacteremia. Patients aged 65 years or older, who had one or more blood cultures positive for E. coli and K. pneumoniae and who were hospitalized between January 2006 and December 2010 at a tertiary-care teaching hospital, were included. 191 bacteremic elderly patients were eligible for the study. The all-cause 28-day mortality rate was 24.6% (47/191). In multivariate analysis, prior antimicrobial therapy (p= 0.014) and an elevated SOFA score (p< 0.001) were independent risk factors for increased mortality, while urinary tract infection (UTI) was an independent determinant for non-mortality (p= 0.011). In the current study, prior antimicrobial therapy within 30 days, an elevated SOFA score and nonurinary source of infection were significantly associated with adverse outcomes in elderly patients with ESBL-producing gram-negative bacteremia.

AB - Gram-negative bacteremia is common in elderly patients and, compared with younger patients, mortality rates in bacteremic elderly patients are high. ESBL-producing organisms were one of the most important risk factors associated with mortality. In addition, older age is one of risk factors for colonization or infection with ESBL-producing organisms. We conducted a retrospective cohort study to evaluate risk factors of all-cause 28-day mortality in elderly patients with ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacteremia. Patients aged 65 years or older, who had one or more blood cultures positive for E. coli and K. pneumoniae and who were hospitalized between January 2006 and December 2010 at a tertiary-care teaching hospital, were included. 191 bacteremic elderly patients were eligible for the study. The all-cause 28-day mortality rate was 24.6% (47/191). In multivariate analysis, prior antimicrobial therapy (p= 0.014) and an elevated SOFA score (p< 0.001) were independent risk factors for increased mortality, while urinary tract infection (UTI) was an independent determinant for non-mortality (p= 0.011). In the current study, prior antimicrobial therapy within 30 days, an elevated SOFA score and nonurinary source of infection were significantly associated with adverse outcomes in elderly patients with ESBL-producing gram-negative bacteremia.

UR - http://www.scopus.com/inward/record.url?scp=84885949583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885949583&partnerID=8YFLogxK

U2 - 10.1016/j.archger.2013.07.002

DO - 10.1016/j.archger.2013.07.002

M3 - Article

VL - 58

SP - 105

EP - 109

JO - Archives of Gerontology and Geriatrics

JF - Archives of Gerontology and Geriatrics

SN - 0167-4943

IS - 1

ER -