MEDICAL CHART REVIEW ON THE CLINICAL CHARACTERISTICS OF PATIENTS WITH COMMUNITY-ACQUIRED INVASIVE E. COLI DISEASE

Abstract

Intro: The objective of this medical chart review (MCR) was to describe the clinical characteristics of elderly patients with community-acquired invasive Escherichia coli disease (IED), as well as their treatment, clinical outcomes, and the associated medical resource use in Germany. Methods: This retrospective MCR study utilized data documented from 11 hospitals across Germany. Hospitals searched their in-house electronic medical record system to identify IED cases (E. coli mono-infection, age ≥60) hospitalized between January 2018 and February 2020. Two mutually exclusive groups were identified through a clinical case definition (CCD): E. coli in blood or other sterile sites (Group B) or E. coli in urine, with the presence of urosepsis and without identifiable other sources of infection (Group U). Cases were subsequently excluded if the infection was hospital-acquired or if they did not meet the CCD. Findings: Of 221 documented IED cases, 134 (60.60%) were ultimately eligible (mean age: 77.98 ± 8.52, females: 47.01%). Of these, 107 (79.85%) were in group B and 27 (20.15%) in group U. Across both groups, the average length of hospitalization was 13.07 ± 11.37 days, and most patients were admitted as emergencies (91.79%). The most common encoded main diagnoses were sepsis due to E. coli (ICD-10: A41.51; 38.06%) and unspecified urinary tract infection (ICD-10: N39.0; 11.94%). The patients' average sepsis-related organ failure assessment score was 3.21 ± 2.43 at admission; 8.96% of patients had a septic shock, and 29.85% were in the intensive care unit during their hospitalization. In total, 10.45% of the patients died during their index hospitalization; of the surviving patients, 18.33% had at least one readmission within 90-days after discharge. Conclusion: In elderly patients (age ≥60) with IED, severe courses associated with increased health care resource utilization and sometimes fatal outcomes were observed. Therefore, advances in recognition and treatment seem to be necessary.