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.

我们利用欧洲最大的法国大学医院集团的临床数据仓库，研究了社区发病菌血症的抗菌药物耐药性与 1 年菌血症复发之间的联系。我们纳入了因社区发病的金黄色葡萄球菌、大肠杆菌或克雷伯氏菌而住院的成年患者。 2017-2019 年菌血症。我们使用 Fine-Gray 回归模型评估了 1 年复发的危险因素。在纳入的 3,617 名患者中，291 名 (8.0%) 的复发次数> 1 次。第三代头孢菌素 (3GC) 耐药性与克雷伯菌属事件后复发风险增加显着相关。 （风险比 3.91 [95% CI 2.32–6.59]）或大肠杆菌（风险比 2.35 [95% CI 1.50–3.68]）菌血症。金黄色葡萄球菌菌血症中的甲氧西林耐药性对复发风险没有影响。尽管一些潜在的疾病和感染源增加了复发风险，但 3GC 耐药的克雷伯菌属。与最大的增幅相关。这些结果证明了 3GC 抗性克雷伯氏菌引起的疾病的一个新方面。和社区环境中的大肠杆菌。