Mortality and length of hospital stay after bloodstream infections caused by ESBL-producing compared to non-ESBL-producing .

OBJECTIVE

To compare mortality and length of hospital stay between patients with ESBL-producing bloodstream infections (BSIs) and patients with non-ESBL BSIs. We also aimed at describing risk factors for ESBL-producing BSIs and time to effective antibiotic treatment for the two groups.

METHODS

A retrospective case-control study among adults admitted between 2014 and 2021 to a Norwegian University Hospital.

RESULTS

A total of 468 BSI episodes from 441 patients were included (234 BSIs each in the ESBL- and non-ESBL group). Among the ESBL-producing BSIs, 10.9% (25/230) deaths occurred within 30 days compared to 9.0% (21/234) in the non-ESBL group. The adjusted 30-day mortality OR was 1.6 (95% CI 0.7-3.7,  = 0.248). Effective antibiotic treatment was administered within 24 hours to 55.2% (129/234) in the ESBL-group compared to 86.8% (203/234) in the non-ESBL group. Among BSIs of urinary tract origin ( = 317), the median length of hospital stay increased by two days in the ESBL group (six versus four days,  < 0.001). No significant difference in the length of hospital stay was found for other sources of infection ( = 151), with a median of seven versus six days ( = 0.550) in the ESBL- and non-ESBL groups, respectively.

CONCLUSION

There was no statistically significant difference in 30-day mortality in ESBL-producing compared to non-ESBL BSI, despite a delay in the administration of an effective antibiotic in the former group. ESBL-production was associated with an increased length of stay in BSIs of urinary tract origin.