Antibiotic exposure in the community and resistance patterns of Escherichia coli community-acquired bloodstream infection

Bat Sheva Gottesman, Pnina Shitrit, Michal Katzir, Michal Chowers

Research output: Contribution to journalArticlepeer-review


Background: Increasing antibiotic resistance in the community results in greater use of empiric broad spectrum antibiotics for patients at hospital admission. As a measure of antibiotic stewardship it is important to identify a patient population that can receive narrow spectrum antibiotics. Objectives: To evaluate resistance patterns of Escherichia coli bloodstream infection (BSI) from strictly community-acquired infection and the impact of recent antibiotic use on this resistance. Methods: This single center, historical cohort study of adult patients with E. coli BSI was conducted from January 2007 to 2011. Patients had no exposure to any healthcare December facility and no chronic catheters or chronic ulcers. Data on 90 days was collected and antibiotic use during the previous relation to resistance patterns was assessed. 267 BSI cases met the Results: Of the total number of patients, (57%) had bacteria sensitive to all entry criteria; 153 patients 189 patients with no antibiotic exposure, antibiotics. Among 61% of isolates (116) were pan-sensitive. Resistance to any 114 patients and 12 were extended-spectrum antibiotic appeared in beta-lactamase (ESBL) producers. Quinolone use was the main driver of resistance to any antibiotic and to ESBL resistance patterns. In a multivariate analysis, older age (odds 1.1) and quinolone use (odds ratio 7) were independently ratio correlated to ESBL. Conclusions: At admission, stratification by patient characteristics and recent antibiotic use can help personalize primary empirical therapy.

Original languageEnglish
Pages (from-to)382-384
Number of pages3
JournalIsrael Medical Association Journal
Issue number6
StatePublished - Jun 2018


  • Community acquired bacteremia
  • Escherichia coli
  • Quinolones
  • Resistance


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