Epidemiology and Outcomes of Community-Acquired Escherichia coli Pneumonia

Abstract

Objective To describe the epidemiology, risk factors and outcomes of community-acquired Escherichia coli pneumonia in comparison to other gram-negative and pneumococcal pneumonias. Methods E.coli is an under recognized cause of bacterial community-acquired pneumonia (CAP). We conducted a large retrospective cohort study of adult patients admitted with pneumonia to 173 US hospitals included in Premier Research database from July 2010–June 2015. Patients were included if they had principal diagnosis code for pneumonia, or a principal diagnosis of respiratory failure or sepsis with secondary diagnosis of pneumonia and had a positive blood or respiratory culture obtained on hospital day 1. The primary outcome was in-hospital case fatality. Secondary outcomes included intensive care unit (ICU) admission, invasive mechanical ventilation (IMV) and use of vasopressors. Results Of 8,680 patients with pneumonia and positive blood or respiratory cultures, 1,029 (7.7%) had E.coli CAP. Patients with E.coli pneumonia were older and more likely to have a principal diagnosis of sepsis. Patients with E.coli pneumonia had significantly higher case fatality than patients with pneumococcal pneumonia (adjusted odds ratio, 1.55 [95% CI, 1.23–1.97]) but not significantly different than other gram-negative pneumonias (adjusted odds ratio, 1.06 [95% CI, 0.85–1.32]). Approximately 36% of the isolates were resistant to fluoroquinolones; 9.3% were resistant to ceftriaxone. Conclusions E.coli is an important cause of severe CAP; with higher mortality than pneumococcal pneumonia but similar to other gram-negative pneumonias. The rate of fluoroquinolone resistance was high and empiric fluoroquinolones should be used with caution in these patients.

ALD based nanostructured zinc oxide coated antiviral silk fabric

“…In the respiratory secretions of cystic fibrosis (CF) patients, E. coli has been isolated frequently. 35 Hence to evaluate the antibacterial efficiency of the ZnO-Silk sample E. coli has been preferred as a study organism. E. coli has also been tested with different ZnO nanostructures.…”

Refractory Escherichia Coli Pneumonia: A Case Report

“…It was also noted that 57% of the E. coli isolates in patients with pneumonia were of urinary origin [ 5 ]. Of all the types of pathogenicity of E. coli , pneumonia is the least discussed in many studies [ 1 , 10 ].…”

“…The study by John et al presented 1029 patients with E. coli pneumonia, of which 40% required ICU admission, 20% required respiratory support, and 14% in-hospital mortality rate. These patients also had a higher mortality rate compared to gram-positive associated community-acquired pneumonia, however, had similar rates compared to other gram-negative bacteria [ 1 ]. In addition, the pneumonia PORT study recorded patients with E. coli pneumonia as having a pneumonia severity index of 4-5, representing expected mortality as high as 27% at 30 days and 21% at 90 days [ 14 ].…”

“…Escherichia coli (E. coli) pneumonia is considered a rare phenomenon. Most community-acquired pneumonia is caused by gram-positive bacteria, such as Streptococcus pneumoniae and Staphylococcus aureus, however, gram-negative bacteria are being recognized more often recently [1]. Previous studies have reported that E. coli make up only 3-12% of all community-acquired pneumonia pathogens [2][3][4].…”

A Diagnostic Quandary of Escherichia Coli Pneumonia: A Case Report and Literature Review

“…In the United States, E. coli is responsible for 265,000 illnesses and about 100 deaths annually [ 5 ]. Clinical syndromes of pathogenic E. coli usually include diarrhoea/dysentery, biliary tract infections, urinary tract infections, and meningitis [ 6 ]. E. coli variants responsible for extraintestinal infections have been labelled ExPEC.…”