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We investigated links between antimicrobial resistance in community-onset bacteremia and 1-year bacteremia recurrence by using the clinical data warehouse of Europe's largest university hospital group in France. We included adult patients hospitalized with an incident community-onset Staphylococcus aureus, Escherichia coli, or Klebsiella spp. bacteremia during 2017-2019. We assessed risk factors of 1-year recurrence using Fine-Gray regression models. Of the 3,617 patients included, 291 (8.0%) had >1 recurrence episode. Third-generation cephalosporin (3GC)-resistance was significantly associated with increased recurrence risk after incident Klebsiella spp. (hazard ratio 3.91 [95% CI 2.32-6.59]) or E. coli (hazard ratio 2.35 [95% CI 1.50-3.68]) bacteremia. Methicillin resistance in S. aureus bacteremia had no effect on recurrence risk. Although several underlying conditions and infection sources increased recurrence risk, 3GC-resistant Klebsiella spp. was associated with the greatest increase. These results demonstrate a new facet to illness induced by 3GC-resistant Klebsiella spp. and E. coli in the community setting.

Original publication





Emerg Infect Dis

Publication Date





974 - 983


Escherichia coli, France, Klebsiella, Staphylococcus aureus, antimicrobial resistance, bacteremia, bacteria, community-acquired infections, drug resistance, recurrence, Humans, Bacteremia, Klebsiella, Male, Risk Factors, Escherichia coli, Female, Community-Acquired Infections, Middle Aged, Aged, Recurrence, Anti-Bacterial Agents, Staphylococcus aureus, Staphylococcal Infections, Escherichia coli Infections, Klebsiella Infections, Drug Resistance, Bacterial, Adult, France