Objective        To identify the risk factors for acquisition of cefepime (FEP) resistance among Escherichia coli (E. coli) isolates in sterile body fluid.       Methods        A total of 288 successive and non-duplicate E. coli strains isolated from sterile body fluid specimens during July 2012 to August 2013 in our department were recruited for case-control study. Ninety-six case was defined as FEP-resistant isolates while 192 cases with FEP-susceptive isolates served as control. Logistic regression was performed to evaluate the independent risk factors.       Results        Out of the 288 total isolates

33.3% (96/288) were resistant to FEP. Production of extended spectrum beta-lactamases (ESBLs)

previous antibiotic use

≥10 d of hospital stay before infection and male were the independent risk factors associated with FEP-resistant E. coli isolates. Other major risk factors included previous use of cephalosporins

mechanical ventilation

drainage tube

urinary or intravenous catheterization.       Conclusion       Patients (especially male) with above-mentioned risk factors should be kept to a shorter hospital stay

less invasive operations and more cautious use of cephalosporins in order to control the emergence of cefepime-resistant strains.