What are the implications of Escherichia coli (E. coli) bacteremia?

From the Guidelines

E. coli bacteremia has severe implications, including increased mortality, long-term disability, and significant economic burden.

Implications of E. coli Bacteremia

• Increased mortality: E. coli bacteremia can lead to sepsis, which has a high mortality rate if not treated promptly and effectively 1.
• Long-term disability: Survivors of E. coli bacteremia may experience long-term disability, reducing their quality of life and increasing the economic burden on their families and the healthcare system.
• Excess length of stay (LOS) in hospitals: E. coli bacteremia can result in an additional LOS of over 10 days, increasing healthcare costs and resource utilization 1.
• Economic burden: The aggregate cost of septicemia, which can be caused by E. coli bacteremia, was $15.4 billion in 2009, accounting for 4.3% of all hospital costs in the US 1.

Importance of Rapid Diagnosis and Treatment

• Rapid identification of bloodstream pathogens, including E. coli, is crucial for timely and effective patient care 1.
• The sooner appropriate antimicrobials are prescribed, the lower the mortality rate for patients with sepsis caused by E. coli bacteremia 1.

From the Research

Implications of Escherichia coli (E. coli) Bacteremia

The implications of E. coli bacteremia are severe and can lead to increased mortality, particularly in certain populations. Some of the key implications include:

• Increased risk of mortality, especially in older adults and those with underlying comorbidities 2, 3, 4, 5
• Higher risk of treatment failure and progression to more serious illness, such as sepsis 2, 6
• Increased length of hospital stay and need for intensive care unit admission 3
• Higher risk of antimicrobial resistance, particularly to extended-spectrum beta-lactamase (ESBL) producing E. coli 4, 5

Risk Factors for E. coli Bacteremia

Several risk factors have been identified as contributing to the development of E. coli bacteremia, including:

• Increasing age 2, 6, 3
• Male gender 2
• Lower socioeconomic status 2
• Prior antimicrobial exposure 2, 4
• Prior treatment failure 2
• Multi-morbidity 2, 3
• Non-urinary portal of entry 6, 4

Antimicrobial Resistance

Antimicrobial resistance is a significant concern in E. coli bacteremia, with resistance to various antibiotics, including:

• Quinolones 3
• Third-generation cephalosporins 3, 5
• Aminoglycosides 3
• ESBL producing E. coli 4, 5 Resistance to these antibiotics can lead to increased mortality and treatment failure 5.