Abstract
Introduction: Rates of community-acquired Escherichia coli bacteraemia (ECB) have been consistently rising. As rates of antimicrobial resistance (AMR), particularly in Gram-negative bacteria, are also increasing, this is of concern both for management of individual patients and healthcare systems. There is currently little data on the risk factors for development of community-acquired ECB: this review aims to identify these risk factors in order to inform community interventions to reduce ECB as well as antibiotic prescribing policy. Methods and analysis: We will search Medline (Ovid), Embase (Ovid), Web of Science/Scopus and the Cochrane Central Register of Controlled Trials for published reports on observational and experimental primary research studies involving patients admitted to hospital with community-acquired ECB. Two reviewers will independently screen the studies for eligibility, perform data collection and assess study quality and risk of bias. Random effects meta-analyses will be performed if appropriate. Ethics and dissemination: No primary data will be collected for this study and so formal ethical approval is not required. We will publish the results of our review in relevant peer-reviewed medical journals, and will also seek to present them at relevant medical conferences. PROSPERO registration number: CRD42018104402.
Highlights
Rates of community-acquired Escherichia coli bacteraemia (ECB) have been consistently rising
As rates of antimicrobial resistance (AMR), in Gram-negative bacteria, are increasing, this is of concern both for management of individual patients and healthcare systems
There is currently little data on the risk factors for development of community-acquired ECB: this review aims to identify these risk factors in order to inform community interventions to reduce ECB as well as antibiotic prescribing policy
Summary
Background Escherichia coli is the commonest organism to be isolated in blood cultures in the UK and elsewhere in Europe[1,2,3]. Whilst rates of MRSA bacteraemia have been decreasing over the past few years, Escherichia coli bacteraemia (ECB) has been consistently increasing[3,4]. This is a worrying phenomenon, as antimicrobial resistance (AMR) in Escherichia coli and other Enterobacteriaceae makes invasive infections progressively more difficult to treat[5]. Show that a large proportion of community-acquired cases are healthcare associated, with patients having had contact with hospital or outpatient services[7]. This potentially increases the scope for interventions that could reduce their incidence. The results may inform community interventions to reduce ECB, as well as inform antibiotic prescribing policy
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