Wang, J., Zhou, M., Hesketh, T. et al. (1 more author) (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. ISSN 1478-7210
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2021 Taylor & Francis. This is an author-produced version of a paper subsequently published in Expert Review of Anti-infective Therapy. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Excess mortality; antimicrobial susceptibility; third-generation cephalosporin; Enterobacteriaceae; Southern China |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 13 Oct 2022 16:40 |
Last Modified: | 15 Oct 2022 01:15 |
Status: | Published |
Publisher: | Informa UK Limited |
Refereed: | Yes |
Identification Number: | 10.1080/14787210.2021.1915767 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:192045 |