BACTEREMIA DUE TO ESCHERICHIA-COLI IN A DANISH UNIVERSITY HOSPITAL, 1986-1990

433 episodes of E. coli bacteraemia over a 5-year period in a Danish u niversity hospital were studied with special emphasis on possible diff erences between nosocomial (NO) and community-acquired (CA) cases. Dat a from 186 males and 247 females with ages ranging from 9 days to 94 y ears were recorded. The average incidence of E. coli bacteraemia was 2 4.4 episodes/10,000 admissions/year. Older females accounted for the l argest number of cases, which reflected the composition of the backgro und population. The highest risk of infection was in males 80-89 years of age. The highest frequency of NO infections was in the departments of Intensive Care (90%) Orthopaedic Surgery (87%) and Haematology (80 %). The most common focus was the urinary tract, with 72% of the episo des with a known focus, while the biliary tract was the focus in 14%. NO bacteraemia was independently related to immunosuppressive therapy, presence of predisposing factors, polymicrobial bacteraemia and prese nce of a non-urinary tract focus. A urinary tract focus was associated with CA bacteraemia, monomicrobial infection, female sex and a normal or elevated total white blood cell count. Patients with NO bacteraemi a had predisposing factors more often than had CA patients, especially haematological malignancies and immunosuppressive therapy. Lack of a known bacterial focus was more common in NO than CA episodes, particul arly among patients with haematologic malignancies. The overall mortal ity was 21%. Increased mortality was independently related to leukopen ia (45%), immunosuppressive therapy and NO bacteraemia.