RT journal article
T1 Association of microbiological factors with mortality in Escherichia coli bacteraemia presenting with sepsis/septic shock: a prospective cohort study
A1 Maldonado, Natalia
A1 López Hernández, Inmaculada
A1 López Cortés, Luis Eduardo
A1 Martínez Pérez-Crespo, Pedro María
A1 Retamar Gentil, Pilar
A1 Galán Sánchez, Fátima
A1 Sánchez Calvo, Juan Manuel
A2 BiomedicinaBiotecnología y Salud Pública
K1 Escherichia coli
K1 Mortality
K1 Sepsis
K1 Septic shock
K1 Virulence
K1 Whole-genome sequencing
AB Objectives: This study aimed to determine the association of Escherichia coli microbiological factors with 30-day mortality in patients with bloodstream infection (BSI) presenting with a dysregulated response to infection (i.e. sepsis or septic shock). Methods: Whole-genome sequencing was performed on 224 E coli isolates of patients with sepsis/septic shock, from 22 Spanish hospitals. Phylogroup, sequence type, virulence, antibiotic resistance, and pathogenicity islands were assessed. A multivariable model for 30-day mortality including clinical and epidemiological variables was built, to which microbiological variables were hierarchically added. The predictive capacity of the models was estimated by the area under the receiver operating characteristic curve (AUROC) with 95% confidence intervals (CI). Results: Mortality at day 30 was 31% (69 patients). The clinical model for mortality included (adjusted OR; 95% CI) age (1.04; 1.02e1.07), Charlson index 3 (1.78; 0.95e3.32), urinary BSI source (0.30; 0.16 e0.57), and active empirical treatment (0.36; 0.11e1.14) with an AUROC of 0.73 (95% CI, 0.67e0.80). Addition of microbiological factors selected clone ST95 (3.64; 0.94e14.04), eilA gene (2.62; 1.14e6.02), and astA gene (2.39; 0.87e6.59) as associated with mortality, with an AUROC of 0.76 (0.69e0.82). Discussion: Despite having a modest overall contribution, some microbiological factors were associated with increased odds of death and deserve to be studied as potential therapeutic or preventive targets.
PB Elsevier
SN 1198-743X
YR 2024
FD 2024
LK http://hdl.handle.net/10498/35555
UL http://hdl.handle.net/10498/35555
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 06-nov-2026