Wang, J;
Zhou, M;
Hesketh, T;
Kritsotakis, EI;
(2021)
Mortality associated with third generation cephalosporin-resistance in Enterobacteriaceae infections: a multicenter cohort study in Southern China.
Expert Review of Anti-infective Therapy
, 19
(11)
pp. 1481-1487.
10.1080/14787210.2021.1915767.
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Abstract
Background: Emerging third-generation cephalosporin-resistant Enterobacteriaceae (3GCR-EB) pose global healthcare concern. This study assessed the in-hospital mortality attributed to 3GCR-EB. / Methods: The study cohort comprised inpatients with community-onset or healthcare-associated infection caused by Enterobacteriaceae in three tertiary-care public hospitals in 2017. In-hospital mortality was compared between 3GCR-EB infected patients and third-generation cephalosporin-susceptible Enterobacteriaceae (3GCS-EB) infected patients using competing risk survival models. / Results: Of 2,343 study patients (median age 60 years; 45.2% male), 1,481 (63.2%) had 3GCS-EB and 862 (36.8%) 3GCR-EB infection. 494 (57.0%) 3GCR-EB isolates were co-resistant to fluoroquinolones and 15 (1.7%) to carbapenems. In-hospital mortality was similar in 3GCS-EB and 3GCR-EB infections (2.4% vs. 2.8%; p = 0.601). No increase in the hazard of in-hospital mortality was detected for 3GCR-EB compared to 3GCS-EB infection (sub-distribution hazard ratio [HR] 0.80; 95%CI, 0.41–1.55) adjusting for patient age, sex, intensive care admission, origin of infection and site of infection. Analysis of cause-specific hazards showed that 3GCR-EB infections significantly decreased the daily rate of hospital discharge (cause-specific HR = 0.84; 95%CI, 0.76–0.92) leading to lengthier hospitalizations. / Conclusion: 3GCR-EB infection per se was not associated with increased in-hospital mortality in this study, but placed significant healthcare burden by increasing the length of hospitalization.
| Type: | Article |
|---|---|
| Title: | Mortality associated with third generation cephalosporin-resistance in Enterobacteriaceae infections: a multicenter cohort study in Southern China |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1080/14787210.2021.1915767 |
| Publisher version: | https://doi.org/10.1080/14787210.2021.1915767 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, Microbiology, Pharmacology & Pharmacy, Excess mortality, antimicrobial susceptibility, third-generation cephalosporin, Enterobacteriaceae, Southern China |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10131591 |
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