Analysis of early-onset bloodstream infection due to Escherichia coli infection in premature babies

作者：Chen I Lun; Huang Hsin Chun; Wu Chih Te; Ou Yang Mei Chen; Chung Mei Yung; Chen Chih Cheng; Suen Jau Ling; Hung Chih Hsing^*

来源：Medicine, 2017, 96(32): e7748.

DOI：10.1097/MD.0000000000007748

• Escherichia coli
• neonate
• premature
• sepsis

In early-onset bacteremia among preterm neonates, Escherichia coli (E. coli) is the main pathogen and can cause a high mortality rate. Thus, the predictive factors of mortality and extended-spectrum beta-lactamase (ESBL)-producing E. coli in preterm babies with E. coli early-onset bacteremia were reported.
We retrospectively reviewed preterm neonates who had E. coli bacteremia occurring within 3 days after birth between 2004 and 2015. Maternal and perinatal information were collected from their medical records and analyzed by comparing the survival and nonsurvival groups, and also the ESBL-producing and non-ESBL-producing E. coli bacteremia groups. Mann-Whitney U test, Fisher exact test, and multivariate Cox proportional-hazard model were used for statistical analysis.
A total of 27 preterm babies had E. coli bacteremia. The overall mortality rate was 55.56% (15 deaths). Five babies had ESBL-producing E. coli. The low systolic blood pressure of <48mm Hg and low absolute neutrophil count of <2318cells/mm(3) were the most significant factors in predicting mortality. Moreover, the level of serum alanine aminotransferase was significantly lower in the ESBL-producing E. coli group than that in the non-ESBL-producing E. coli group.
Therefore, the lower systolic blood pressure and absolute neutrophil count were the risk factors of mortality in preterm babies with early-onset E. coli bacteremia, and alanine aminotransferase could be a significant factor in predicting ESBL-producing E. coli.

• 出版日期2017-8
• 单位河北医科大学