Pritchard, Emma;
Vihta, Karina-Doris;
Lipworth, Samuel;
Pouwels, Koen B;
Stoesser, Nicole;
Hope, Russell;
Muller-Pebody, Berit;
... Walker, A Sarah; + view all
(2025)
An electronic health record-wide association study to identify populations at increased risk of E. coli bacteraemia.
Journal of Infection
, 91
(4)
, Article 106612. 10.1016/j.jinf.2025.106612.
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Abstract
Objectives: Escherichia coli bacteraemias have been under mandatory surveillance in the UK for fifteen years, but cases continue to rise. Systematic searches of all features present within electronic healthcare records (EHRs), described here as an EHR-wide association study (EHR-WAS), could potentially identify under-appreciated factors that could be targeted to reduce infections. // Methods: We used data from Oxfordshire, UK, and an EHR-WAS method developed for use with large-scale COVID-19 data to estimate associations between E. coli bacteraemia cases, hospital-exposed controls, and 377 potential risk factors using Poisson regression models adjusted for potential confounders for three two-year financial year (FY) periods. // Results: FY2022/23–2023/24 analysis included 757 (0.3%) cases and 276,758 (99.7%) controls. We identified six broad disease areas associated with increased or decreased E. coli bacteraemia risk. Renal/urological/urinary tract infection-related variables had the largest impact, with 47% of cases theoretically removed if these factors could be minimised. Cancer-related variables were associated with higher E. coli bacteraemia risk (1.20 times higher (95%CI 1.08–1.34) per three months closer to chemotherapy in the last year), as were gastrointestinal- and infectious disease-related variables. Cardiac/respiratory-related variables were associated with lower E. coli bacteraemia risk, whereas greater healthcare exposure showed no consistent effect. Associated factors varied across periods, but broad groups remained similar. // Conclusions: Applying an EHR-WAS approach, we show E. coli bacteraemias are largely driven by known risk factors and frailty, highlighting the importance of monitoring these factors and targeting modifiable risks where possible.
| Type: | Article |
|---|---|
| Title: | An electronic health record-wide association study to identify populations at increased risk of E. coli bacteraemia |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jinf.2025.106612 |
| Publisher version: | https://doi.org/10.1016/j.jinf.2025.106612 |
| Language: | English |
| Additional information: | Copyright © 2025 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Escherichia coli; Bloodstream infections; Electronic health records; Risk factors; Population health; Infectious disease epidemiology |
| 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 > Inst of Clinical Trials and Methodology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10213264 |
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