The Value of NLR Combined SOFA in Assessing the Prognosis of Sepsis Patients

2021 ◽  
Author(s):  
Yixuan Li ◽  
Junyu Wang ◽  
Bing Wei ◽  
Xiangqun Zhang ◽  
Le Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sofa Score ◽  
Demographic Data ◽  
Area Under The Curve ◽  
Time Data ◽  
Survival Group ◽  
Clinical Research Center ◽  
The Difference ◽  
Predicted Values ◽  
Death Group

Abstract Background: In order to evaluate the risk factors and its assessment values in patients with sepsis, and to explore a method to improve the prognosis prediction efficiency of patients with sepsis.Methods: Patients with sepsis admitted to Emergency Medicine Clinical Research Center, Beijing Chao-Yang Hospital, Capital Medical University from January 2020 to December 2020 were enrolled, and they were divided into survival group and death group according to the prognosis at 28 days. Demographic data of patients and laboratory values at admission were collected. In terms of the first time data within 24h of patients admitted to hospital, the sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score were calculated, and compared the difference between the two groups, the logistic regression was used to analysis the risk factors for death within 28 days, as well as the calculated combined predictor of SOFA and neutrophil to lymphocyte ratio (NLR). Predicted values of various indicators for 28 days’ mortality in sepsis patients were analyzed by receiver operating characteristic (ROC) curve.Results: 302 patients in total were included in this study, including 238 patients in survival group and 64 patients in death group. The age (78.36±9.8 years old vs. 71.6±14.1 years old), procalcitonin (PCT) (1.00 ng/ml vs. 0.05 ng/ml), C-reactive protein (CRP) (93 mg/l vs 14 mg/l), lactic acid (Lac) (1.20 mmol/l vs. 2.20 mmol/l), NLR (11.7 vs. 6.20), SOFA score (8 vs. 4) and APACHE Ⅱ score(20.5 vs. 11.0) of death group were significantly higher than those of survival group (all P<0.001). Age (OR=1.046, 95%CI 1.020-1.074, P=0.001), PCT (OR=1.115, 95%CI 1.055-1.177, P<0.001), CRP (OR=1.016, 95%CI 1.011-1.021, P<0.001), Lac (OR=1.887, 95%CI 1.518-2.346, P<0.001), NLR (OR=1.038, 95%CI 1.016-1.060, P=0.001), APACHE Ⅱ score (OR=1.231, 95%CI 1.166-1.300, P<0.001), SOFA score (OR=1.499, 95%CI1.344-1.671, P<0.001), NLR combined SOFA (SOFA+NLR×0.085) (OR=1.492, 95%CI1.341-1.660, P<0.001) were risk factors of 28 days’ mortality in sepsis patients, and the area under the curve (AUC) of APACHE Ⅱ, NLR combined SOFA were 0.853 and 0.855, higher than Lac (0.767, P<0.05), CRP (0.746, P<0.05) and PCT (0.761, P<0.05), the AUC of APACHE Ⅱ was similar with NLR combine SOFA (P>0.05). The sensitivity and specificity of APACHE Ⅱ and NLR combined SOFA to predict the 28 days’ prognosis of sepsis patients were better than the other indicators. Conclusion: NLR combined SOFA was a risk factor for the death of sepsis patients, and its predictive efficacy was similar with that of APACHE Ⅱ score, which is superior to other predictive indexes.

scholarly journals ANALYSIS OF PROGNOSTIC RISK FACTORS OF BLOODSTREAM INFECTIONS IN BEIJING COMMUNITIES: A RETROSPECTIVE STUDY FROM 2015 TO 2019

2021 ◽  
Vol 13 (1) ◽  
pp. e2021060
Author(s):  
Yan Liu ◽  
Beichen Cui ◽  
Chunmei Pi ◽  
Xiaohong Yu ◽  
Zhiwei Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Protective Factor ◽  
Bloodstream Infections ◽  
Survival Group ◽  
Indwelling Catheters ◽  
Factors Affecting ◽  
Independent Risk Factors ◽  
Prognostic Risk Factors ◽  
Death Group

Objective: This study intends to investigate the prognostic risk factors of bloodstream infection in Beijing. Methods: This study is a clinical retrospective study. Patients with community-onset bloodstream infections (COBSI) who were admitted to the emergency department and inpatient department of Beijing Jishuitan Hospital from January 1,2015 to December 31,2019 were selected as the main research objects. According to whether the patient survives for 100 days or not, the patients are divided into survival group and death group. By analyzing the clinical data of the two groups of patients, the epidemiology, clinical characteristics, bacterial resistance and risk factors affecting the prognosis of the patients were analyzed. Results: A total of 446 patients with COBSI diagnosed by blood culture were included in this study, including 252 men and 194 women. According to 100-day survival or not, patients were divided into survival group and death group, of which 363 cases were in the survival group and 83 cases were in the death group. The results of this study show that solid tumors, combined septic shock, indwelling catheters and hemodialysis treatment are independent risk factors affecting the prognosis of COBSI patients. Reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients. Conclusion: Solid tumors, combined septic shock, indwelling catheters, hemodialysis treatment, Charlson score, APACHE II score and PITT score are independent risk factors affecting the prognosis of COBSI patients in Beijing, the capital of China, and reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients.

scholarly journals Does an Increase in Serum FGF21 Level Predict 28-day Mortality of Critical Patients with Sepsis and ARDS?

2021 ◽  
Author(s):  
Xing Li ◽  
Hua Shen ◽  
Tinghong Zhou ◽  
Xiaoyu Cao ◽  
Ying Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Level ◽  
Sofa Score ◽  
Proportional Hazards ◽  
Demographic Data ◽  
Serum Levels ◽  
Cox Proportional Hazards ◽  
Fibroblast Growth Factor 21 ◽  
Icu Patients ◽  
Fgf21 Level

Abstract BackgroundSepsis may be accompanied by acute respiratory distress syndrome (ARDS) in patients admitted to intensive care units (ICUs). It is essential to identify prognostic biomarkers in patients with sepsis and ARDS.ObjectiveDetermine whether changes in the level of serum fibroblast growth factor 21 (FGF21) can predict the 28-day mortality of ICU patients with sepsis and ARDS.MethodsConsecutive sepsis patients were divided into two groups (Sepsis+ARDS and Sepsis-only), and the Sepsis+ARDS group was further classified as survivors or non-survivors. Demographic data and comorbidities were recorded. The Sequential Organ Failure Assessment (SOFA) score and serum levels of cytokines and other biomarkers were recorded 3 times after admission. Multiple Cox proportional hazards regression was used to identify risk factors associated with 28-day mortality in the Sepsis+ARDS group.ResultsThe Sepsis+ARDS group had a greater baseline SOFA score and serum levels of cytokines and other biomarkers than the Sepsis-only group; the serum level of FGF21 was almost 2-fold greater in the Sepsis+ARDS group (P<0.05). Non-survivors in the Sepsis+ARDS group had an almost 5-fold greater level of FGF21 than survivors in this group (P<0.05). The serum level of FGF21 persistently increased from the baseline to the peak of shock and death in the non-survivors, but persistently decreased in survivors (P<0.05). Changes in the serum FGF21 level between different time points were independent risk factors for mortality.ConclusionA large increase of serum FGF21 level from baseline is associated with 28-day mortality in ICU patients with sepsis and ARDS.

scholarly journals PREVENTION OF RISK FACTORS OF CARDIOVASCULAR DISEASE IN NURSING

2017 ◽  
Vol 5 ◽  
pp. 988-993
Author(s):  
Mária Novysedláková ◽  
RĂłbert Ĺ eliga
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Demographic Data ◽  
Organ Damage ◽  
Empirical Survey ◽  
Education Of Patients ◽  
Preventive Check ◽  
Significant Difference ◽  
Males And Females ◽  
The Difference

Introduction: Cardiovascular disease, in terms of its frequency, the severity of organ damage, and the consequences for the health of the population constitutes one of the most pressing problems of our population. The prevention of subsequent coronary events and the maintenance of physical functioning in such patients are a major challenge in preventive care. However, many patients opt for a change in their lifestyle, some with the support of a health professional.Objective: This empirical survey focuses on the knowledge of respondents about preventing cardiovascular disease. Statistical methods determine the differences between males and females in attending preventive check-ups, understanding and observing risk factors in their lifestyle, and having an interest in changing their lifestyle.Methods: The survey uses a non-standardized questionnaire. Apart from demographic data, the questionnaire had 10 items assessing the respondent’s knowledge of risk factors for cardiovascular disease, 10 on lifestyle and attitudes to the change in lifestyle, and five regarding their interest in education about the subject. Exploratory data includes answers from 70 respondents, who were outpatients in a general practitioner’s department. Of these, 32 are males (46.0%) and 38 are females (54.0%). Results of the survey are analyzed using the Chi-Squared test. Results: Fifty-four of the 70 respondents (55.7%; 20 males and 34 females) undertake preventive check-ups at the general practitioner’s department at least once in two years. No significant differences present between males and females in attending preventive check-ups (χ2 = 3.455; df = 1; P = 0.05) and in showing a willingness for a lifestyle change (χ2 = 1.789; P = 0.05). However, based on the given data, a significant difference presents between males and females regarding proper regime observance (χ2 = 18.651; df = 1; P = 0.05). For example, females know the observance of a healthy diet is necessary for preventing ischemic heart disease (χ2 = 20.124; df = 1; P = 0.05).Conclusion: The study shows that the difference between males and females is significant regarding their understanding of risk factors related to lifestyle and proper regime observance. Thus, education could lead to reducing or eliminating such risk factors. Prevention of risk factors is complex and lifelong. Under conditions of the Slovak health service, registered nurses are responsible for the education of patients.

scholarly journals Value of Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio, and Red Blood Cell Distribution Width in Evaluating the Prognosis of Children with Severe Pneumonia

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xuejiao Qi ◽  
Yihui Dong ◽  
Xiaojie Lin ◽  
Wencheng Xin
Keyword(s):  
Risk Factors ◽  
Severe Pneumonia ◽  
Apache Ii Score ◽  
Cell Distribution ◽  
Platelet To Lymphocyte Ratio ◽  
Survival Group ◽  
Distribution Width ◽  
Lymphocyte Ratio ◽  
Death Group ◽  
Red Blood Cell Distribution

Objective. To investigate the value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in evaluating the prognosis of children with severe pneumonia (SP). Methods. A retrospective analysis of the data of 91 children with SP admitted to our hospital from March 2018 to March 2021. According to the survival status after 28 days of treatment, all children were divided into the survival group (n = 59) and the death group (n = 32). The clinical data and laboratory indicators of the patients were recorded. Multivariate logistic regression was used to analyze the risk factors of prognosis, and the ROC curve was used to analyze the predictive value of each index. Results. The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and CURB-65 score of the death group were higher than those of the survival group ( P < 0.05 ). The RDW, NLR, PLR, and high-sensitivity C-reactive protein, procalcitonin blood lactic acid (Lac) of the death group, were higher than those of the survival group, and LYM was lower than the survival group ( P < 0.05 ). Multivariate regression analysis showed that APACHE II score, RDW, NLR, PLR, and Lac were all independent risk factors for poor prognosis in children with SP ( P < 0.05 ). The AUC of NLR, PLR, and RDW for evaluating the prognosis of children with SP were 0.798, 0.781, and 0.777, respectively. The sensitivity was 56.25%, 90.63%, and 56.25%, respectively, and the specificity was 89.83%, 55.93%, and 91.53%, respectively. The AUC of NLR, PLR, and RDW combined to evaluate the prognosis of children with SP was 0.943. When the best cut-off value was 0.8528, the sensitivity was 93.75%, and the specificity was 91.53%. Conclusion. NLR, PLR, and RDW have certain predictive value for the prognosis of children with SP; the combination of the three indicators has a higher value in evaluating the prognosis of children with SP, which can better guide the prognostic treatment.

scholarly journals Cardiac arrest survival post-resuscitation in-hospital (CASPRI)—a tool to predict neurological outcome after ROSC

2020 ◽  
Author(s):  
Bofu Liu ◽  
Yarong He ◽  
Peng Jiang ◽  
Jiachen Sun ◽  
Tianyong Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Roc Curve ◽  
Sofa Score ◽  
Test Group ◽  
Neurological Function ◽  
Neurological Prognosis ◽  
The Difference ◽  
Cardiac Arrest Survival

Abstract Objectives: To develop a cardiac arrest survival post-resuscitation in-hospital (CASPRI) scoring system evaluating the prognosis of neurological function in ROSC patients.Methods: This single-center, retrospective study reviewed the eligible patients admitted to the emergency department of West China Hospital of Sichuan University who received cardiopulmonary resuscitation and restored spontaneous circulation from January 1, 2014 00:00 to December 31, 2017 23:59. Clinical histories, blood test, biochemistry profile, coagulation indexes and other laboratory tests during emergency department visit were collected. The MEWS, sOHCA, APACHE II, and the highest SOFA scores were calculated during the period between emergency room admission and ROSC. The clinical data of ROSC patients in the test group were analyzed by univariate and multivariate logistic analysis. The possible risk factors related to the unfavorable prognosis of 90-day neurological function were screened and CASPRI score was constructed. The efficacy of CASPRI score on evaluating the neurological function of ROSC patients was analyzed by ROC curve and proved in the validation group.Main results: 503 patients were included in the test group. After correcting potential confounding factors, multivariate logistic regression analysis showed that TBIL, ALB at admission of emergency department, Lac at ROSC, resuscitation time, non-shockable rhythms were independent risk factors for poor neurological prognosis of ROSC patients (p<0.05). ROC curve showed that the CASPRI score was superior to the APACHE II score, SOFA score, MEWS score and sOHCA score, and the difference was statistically significant (p<0.05). In the validation group with 256 patients included, the incidence of poor neurological prognosis in high-risk, intermediate-risk, and low-risk groups based on CASPRI score were 97.89%, 85.59%, and 58.33%, respectively, and the difference was statistically significant (p<0.001). CASPRI score was superior to the SOFA score and MEWS score, the difference was statistically significant (p<0.05).Conclusions: CASPRI score is an effective tool for the early evaluation of the neurological prognosis of ROSC patients. Its efficacy exceeds the MEWS and SOFA scoring systems currently used in clinical practice.

scholarly journals Risk factors related balance disorder for patients with dizziness/vertigo

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhentang Cao ◽  
Cuiting Zhu ◽  
Yanan Zhou ◽  
Yan Wang ◽  
Meimei Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Operating Characteristic ◽  
Optokinetic Nystagmus ◽  
Demographic Data ◽  
Area Under The Curve ◽  
Final Analysis ◽  
Medical Data ◽  
Limits Of Stability ◽  
Balance Disorder ◽  
Romberg Test

Abstract Background When dizziness/vertigo patients presented with balance disorder, it will bring severe morbidity. There is currently lack of research to explore risk factor related balance disorder in dizziness patients, especially in those who walk independently. Aim To investigate risk factors related balance disorder in dizziness/vertigo patients who walk independently. Methods Medical data of 1002 dizziness/vertigo patients registered in vertigo/balance disorder registration database were reviewed. The demographic data, medical history, and risk factors for atherosclerosis (AS) were collected. Enrolled dizziness/vertigo patients could walk independently, completed Romberg test, videonystagmography (VNG), and limits of stability (LOS). The subjective imbalance was patient complained of postural symptom when performing Romberg test. Multivariable logistic regression analyzed risk factors related balance disorder. The receiver operating characteristic (ROC) curve evaluated the utility of regression model. Results Five hundred fifty-three dizziness/vertigo patients who walk independently were included in the final analysis. According to LOS, patients were divided into 334 (60%) normal balance and 219 (40%) balance disorder. Compared with normal balance, patients with balance disorder were older (P = 0.045) and had more risk factors for AS (P<0.0001). The regression showed that risk factors for AS (OR 1.494, 95% CI 1.198–1.863), subjective imbalance (OR 4.835, 95% CI 3.047–7.673), and abnormality of optokinetic nystagmus (OR 8.308, 95% CI 1.576–43.789) were related to balance disorder. The sensitivity and specificity of model were 71 and 63% (P<0.0001). The area under the curve (AUC) was 0.721. Conclusions Risk factors for AS, subjective imbalance, and abnormality of optokinetic nystagmus were predictors for balance disorder in patients with dizziness/vertigo who walk independently.

scholarly journals Does an increase in serum FGF21 level predict 28-day mortality of critical patients with sepsis and ARDS?

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xing Li ◽  
Hua Shen ◽  
Tinghong Zhou ◽  
Xiaoyu Cao ◽  
Ying Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Serum Level ◽  
Sofa Score ◽  
Demographic Data ◽  
Characteristic Curve ◽  
Serum Levels ◽  
Cox Proportional Hazards ◽  
Fibroblast Growth Factor 21 ◽  
Icu Patients ◽  
Fgf21 Level

Abstract Background Sepsis may be accompanied by acute respiratory distress syndrome (ARDS) in patients admitted to intensive care units (ICUs). It is essential to identify prognostic biomarkers in patients with sepsis and ARDS. Objective Determine whether changes in the level of serum fibroblast growth factor 21 (FGF21) can predict the 28-day mortality of ICU patients with sepsis and ARDS. Methods Consecutive sepsis patients were divided into two groups (Sepsis + ARDS and Sepsis-only), and the Sepsis + ARDS group was further classified as survivors or non-survivors. Demographic data and comorbidities were recorded. The Sequential Organ Failure Assessment (SOFA) score and serum levels of cytokines and other biomarkers were recorded 3 times after admission. Multiple Cox proportional hazards regression was used to identify risk factors associated with 28-day mortality in the Sepsis + ARDS group. Multivariate receiver operating characteristic curve analysis was used to assess the different predictive value of FGF21 and SOFA. Results The Sepsis + ARDS group had a greater baseline SOFA score and serum levels of cytokines and other biomarkers than the Sepsis-only group; the serum level of FGF21 was almost twofold greater in the Sepsis + ARDS group (P < 0.05). Non-survivors in the Sepsis + ARDS group had an almost fourfold greater level of FGF21 than survivors in this group (P < 0.05). The serum level of FGF21 persistently increased from the baseline to the peak of shock and death in the non-survivors, but persistently decreased in survivors (P < 0.05). Changes in the serum FGF21 level between different time points were independent risk factors for mortality. No statistical difference was observed between the AUC of FGF21 and SOFA at baseline.  Conclusion A large increase of serum FGF21 level from baseline is associated with 28-day mortality in ICU patients with sepsis and ARDS.

scholarly journals The Death Risk Factors of Patients Undergoing Re-Exploration For Bleeding or Tamponade After Isolate Off-Pump Coronary Artery Bypass Grafting: A Case-Control Study

2021 ◽  
Author(s):  
Tongxiao Luan ◽  
Yingzhu Zhuang ◽  
Weihong Nie ◽  
Sumin Yang ◽  
Yuhui Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Survival Group ◽  
Death Risk ◽  
Off Pump ◽  
Pump Coronary Artery Bypass ◽  
Death Group

Abstract Background: The purpose of this study is to analysis the death risk factors of re-exploration for bleeding or tamponade after isolate off-pump coronary artery bypass grafting (OPCABG).Methods: We analyzed the data of 3256 consecutive patients undergoing isolate OPCABG in our heart center from 2013 through 2020. Fifty-eight patients undergonere-exploration after OPCABG. The 58 patients were divided into death group and survival group according to their discharge status, and the risk factors of death were analyzed.Results: The mortality rate was 27.59% (16/58).We found the patients indeath group had higherbody mass index (BMI) (P=0.03), higher cardiac troponin T (cTnT) (P =0.028) and higher incidence of heart failure before OPCABG (P = 0.003). The levels of lactic acid before and after re-exploration (P =0.011 and P <0.001) were higher in death group. And the levels of creatinine (P = 0.003) and partial pressure of carbon dioxide (PCO2) (P = 0.021) were higher in the death group after re-exploration. The death group had longer reoperation time (P = 0.002).In addition, the perioperative utilization rate of intra-aortic ballon pump (IABP) (P = 0.029), continuous renal replacement therapy (CRRT) (P = 0.001) and platelet transfusion (P = 0.009) were higher than survival group. Conclusions: The mortality rate of patients undergoing re-exploration for bleeding or tamponade after isolate OPCABG is high. More attention should be paid to patients withabove risk factors and appropriate measures should be taken in time.

scholarly journals Comparison of the Value of SOFA and Pitt Bacteremia Scores in the Prognostic Evaluation of Patients With Hospital-acquired Klebsiella Pneumoniae Bloodstream Infection

2021 ◽  
Author(s):  
Jun Guo ◽  
Shuaihua Fan ◽  
Jinlan Lin ◽  
Sheng Wu
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Sofa Score ◽  
Tertiary Hospital ◽  
Klebsiella Pneumonia ◽  
Survival Group ◽  
Hospital Acquired Infection ◽  
Prognostic Evaluation ◽  
The Difference ◽  
Hospital Acquired

Abstract This clinical research studied the value of SOFA score and Pitt bacteremia score in the prognosis assessment of patients with hospital-acquired Klebsiella pneumonia bloodstream infection. We conducted a retrospective analysis of 40 patients with hospital-acquired Klebsiella pneumoniae bloodstream infection in a tertiary hospital from January 2016 to December 2020. For these patients, the SOFA score and Pitt bacteremia score were used to evaluate the prognosis. Logistic regression was performed with the known prognosis results to obtain the best cut-off value, sensitivity, and specificity. Pitt bacteremia score [3 (3-4) points to 6 (5.5-7) points] and SOFA score [7 (6-10) points to 17 (13-17.5) points] in the survival group were lower than those in the death group (P<0.05). The SOFA score predicts the death of hospital-acquired Klebsiella pneumoniae bloodstream infection patients with a sensitivity of 80%, a specificity of 84%, and the area under curve(AUC) of SOFA score is 0.8960 (95% CI 0.7951-0.9969); Pitt bacteremia score predicts the hospital-acquired Klebsiella pneumoniae blood infection with a sensitivity of 86.67%, a specificity of 80%, and AUC of Pitt bacteremia score is 0.9413 (95% CI 0.8700- 1.000). Both the SOFA score and the Pitt bacteremia score have predictive value for the prognosis of patients with HAI (hospital acquired infection) Klebsiella pneumonia blood infection. However, the difference shows that the SOFA score has obvious accuracy and specificity in the prognosis of patients with HAI Klebsiella pneumoniae bloodstream infection, it is better than the Pitt bacteremia score and has greater application prospects in prognostic evaluation.

Risk Factors and Outcomes of Extended-Spectrum Beta-Lactamase-Producing E. Coli Peritonitis in Capd Patients

2006 ◽  
Vol 26 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Terence Yip ◽  
Kai-Chung Tse ◽  
Man-Fai Lam ◽  
Sydney Tang ◽  
Fu-Keung Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Acid ◽  
Clinical Outcomes ◽  
Demographic Data ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Acid Inhibitor ◽  
Extended Spectrum ◽  
The Difference

Objective To determine the risk factors and outcomes of peritonitis caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli in continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods Episodes of E. coli CAPD peritonitis in our unit from October 1994 to August 2003 were reviewed. Demographic data, underlying medical conditions, recent use of gastric acid inhibitors (including H2 antagonist and proton pump inhibitor), recent antibiotic therapy, antibiotic regimen for peritonitis episodes, sensitivity test results of the E. coli isolated, and clinical outcomes were examined. Results Over a 10-year study period, 88 episodes of E. coli peritonitis were recorded; 11 of the 88 cases were caused by ESBL-producing E. coli. Recent use of cephalosporins and gastric acid inhibitor were associated with the development of ESBL-producing E. coli peritonitis. Compared with non-ESBL-producing E. coli peritonitis, more cases in the ESBL-producing E. coli group developed treatment failure (45.5% vs 13.0%, p = 0.02) and died of sepsis (27.3% vs 3.9%, p = 0.02). Peritoneal failure rate was higher in the ESBL-producing E. coli group, although the difference was not statistically significant (18.2% vs 3.9%, p = 0.12). Conclusion Peritonitis caused by ESBL-producing E. coli is associated with worse clinical outcomes. The use of cephalosporins and gastric acid inhibitors may contribute to its development. Further studies are warranted to investigate and determine the predisposing factors for ESBL-producing E. coli peritonitis.

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