Preventive Interventions Are Needed for Invasive Extraintestinal E coli Disease

Severe infection and antimicrobial resistance (AMR) was frequently observed in older patients with invasive extraintestinal Escherichia coli disease (IED), suggesting the need for preventive interventions for IED. These study results were presented at IDWeek 2022, held from October 19 to 23, in Washington, DC.

Researchers conducted a prospective observational study at 8 hospitals in Europe, North America, and Asia. Hospitalized patients aged 60 years and older with IED confirmed via systemic inflammatory response syndrome (SIRS) or Sequential Organ Failure (SOFA) score assessment were included. The researchers aimed to describe the clinical profile of IED, as well as the pattern of AMR for causative E coli isolates.

A total of 240 patients with IED were enrolled, of whom 51% were women, and the median age was 75 years. Patients had either bacteremic IED (80.4%), confirmed via blood samples, or nonbacteremic IED (19.6%), confirmed via sterile body site and urine samples.

The researchers found the majority of patients with IED had community-acquired disease (50.4%), and 29.6% and 20% had health care-associated (29.6%), and hospital-acquired (20%) disease, respectively. Among the patients, the urinary tract was the most common source of IED (62.9%), and the majority had fever (51.5%) or tachycardia (58.6%).

Further analysis showed 86.3% of patients had laboratory markers suggestive of systemic infection, including leukocytosis (42.7%) and leukopenia (10.9%). The researchers noted SOFA and SIRS scores of 2 or higher in 60.4% and 65.8% of patients, respectively. In addition, 76.5% of patients had sepsis and 10.6% had septic shock.

At 28 days post diagnosis, 14.6% of patients were unrecovered, 4.6% had died, and 12.9% had kidney dysfunction.

Of 238 patients with E coli isolates who underwent testing, 62.6%, 45.9%, and 35.0% had AMR against 1, 2, or 3 or more drug classes, respectively.

According to the researchers, “The data suggest a need of preventive interventions for IED.”