The association of ESBL Escherichia coli with mortality in patients with Escherichia coli bacteremia at the emergency department


  • Pariwat Phungoen Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
  • Jessada Sarunyaparit Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
  • Korakot Apiratwarakul Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
  • Lumyai Wonglakorn Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
  • Atibordee Meesing Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
  • Kittisak Sawanyawisuth Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand



Extended-spectrum beta-lactamase-producing Escherichia coli, Glucose, Lactate


Background: Escherichia coli is a common bloodstream infection pathogen in the emergency department (ED). Patients with extended-spectrum beta-lactamase (ESBL) E. coli have a higher risk of morbidity. However, there is still debate surrounding ESBL E. coli-associated mortality in community, intensive care unit, and tertiary care settings. In addition, there have been few studies regarding mortality in ESBL E. coli in ED settings, and results have been contradictory.

Methods: This was a retrospective cohort study conducted at the Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University in Thailand aimed at evaluating the possible association between ESBL E. coli bacteremia and mortality in the ED. The inclusion criteria were age 18 years or over, clinical presentation suspicious of infection, and positive blood culture for E. coli. Predictors for mortality were analyzed by logistic regression analysis.

Results: During the study period, 273 patients presented at the ED with hemoculture positive for E. coli. Of those, 27 (9.89%) died. Five factors remained in the final model, of which plasma glucose levels, serum lactate levels, and ESBL E. coliwere significantly associated with 28-day mortality in the ED with adjusted odds ratios of 0.970, 1.258, and 12.885, respectively. Plasma glucose of less than 113 mg/dL yielded a sensitivity of 80.95% and specificity of 64.29%, while serum lactate over 2.4 mmol/L had a sensitivity of 81.48% and specificity of 45.50%.

Conclusion: ESBL E. coli, plasma glucose, and serum lactate levels were associated with 28-day mortality in patients with E. coli bacteremia presenting at the ED.


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How to Cite

Phungoen P, Sarunyaparit J, Apiratwarakul K, Wonglakorn L, Meesing A, Sawanyawisuth K. The association of ESBL Escherichia coli with mortality in patients with Escherichia coli bacteremia at the emergency department. dti [Internet]. 2022 Oct. 17 [cited 2022 Dec. 6];16(1):12-6. Available from:



Original Research Article
Received 2022-05-11
Accepted 2022-09-19
Published 2022-10-17

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