Escherichia coli bacteraemia in patients with and without haematological malignancies: A study of strain characters and recurrent episodes

• Published in: The Journal of infection 1998, Vol.36 (1), p.93-100
• Main Authors: Olesen, B., Kolmos, H.J., Ørskov, F., Ørskov, I.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - pharmacology; Bacteremia - complications; Bacteremia - microbiology; Bacteremia - prevention & control; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Child; Child, Preschool; Escherichia coli - classification; Escherichia coli - drug effects; Escherichia coli - isolation & purification; Escherichia coli - pathogenicity; Escherichia coli Infections - complications; Escherichia coli Infections - microbiology; Female; Hematologic Neoplasms - complications; Hematologic Neoplasms - microbiology; Human bacterial diseases; Humans; Infant; Infectious diseases; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Neutropenia - microbiology; Recurrence; Serotyping; Virulence
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/S0163-4453(98)93378-3

We compared serotypes, virulence factors and susceptibility to antibiotics of Escherichia coli strains isolated from 282 patients with bacteraemia. Thirty-five of these were neutropenic patients with haematological malignancy and 247 were patients with a normal or raised total white blood cell count and no haematological malignancy. Strains isolated from recurrent bacteraemia were also bio- and ribotyped. Overall, no significant difference was found between O serogroups, K antigens, serum sensitivity, production of haemolysin, expression of P-fimbriae and patterns of antibiotic susceptibility in the two groups of strains. The haematological patients more often than the non-haematological patients had an unknown focus of infection, recurrent bacteraemia, shorter intervals between recurrences and recurrences caused by identical strains. Despite a well-defined focus, six of eight non-haematological patients had recurrences with a strain different from the strain isolated in a previous episode. A possible connection between shorter intervals and recurrence with identical strains is discussed. We suggest that strains from recurrent E. coli bacteraemia are sent to a reference laboratory for serotyping and possibly ribotyping.