Clinical Risk Factors for Death Caused by Extended-Spectrum Beta-Lactamase: Producing Bacteria

Objectives: Extended-spectrum beta-lactamase (ESBL)-producing bacteria often causes bacteremia, leading serious outcomes. In this study, we conducted a retrospective analysis to identify the risk factors associated with death by bacteremia of ESBL-producing bacteria. Methods: Patients with bacteremia by ESBL-producing bacteria were retrospectively collected in Kobe University Hospital, Japan, between January 2011 and December 2015. Potential risk factors for death caused by ESBL-bacteremia were analyzed for patients' outcome (recovery or death) by univariate and multivariate analysis. Results: A total of 101 patients (64 male and 37 female) were recruited. The most frequently detected ESBL-producing bacteria were Escherichia coli (91 cases; 90.1%), followed by Klebsiella pneumoniae (8 cases; 7.9%). Most frequently used antibiotics after the detection of bacteremia was meropenem (66.3%; 67/101) followed by cefmetazole (51.5%; 52/101). Univariate analysis showed a significantly positive correlation with mortality in ICU admission (p < 0.001), circulatory diseases (p = 0.022), shock (p = 0.044), and respirator requirement (p = 0.002). Multivariate analysis showed ICU admission remained significant risk factor for mortality (p = 0.0192). Conclusions: We showed ICU admission was significantly correlated with death from bacteremia by ESBL-producing bacteria. These factors should be monitored to estimate severity of ESBL causing-bacteremia for better patients' outcomes.