+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis



Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis



ChemoTherapy 58(3): 217-224



To describe the risk factors and molecular epidemiology of nosocomial bloodstream infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in a tertiary care hospital. Patients with enterobacteria-positive blood cultures were included. ESBL expression in the isolates was detected using the combination disk method. Antimicrobial susceptibility testing was performed using the disk diffusion method. bla(SHV), bla(TEM), and bla(CTX-M) genes were identified in the isolated strains by PCR and sequencing. Klebsiella pneumoniae isolates were genotyped by PFGE. Of the 90 isolates recovered, half were found to express ESBLs. Twenty-eight (62%) of these isolates were K. pneumoniae, 8 (18%) were Escherichia coli, 6 (13%) were Enterobacter cloacae, and 3 (7%) were Serratia marcescens. Multivariate logistic regression analysis showed that the only independent risk factor associated with infection by ESBL-producing strains was use of broad-spectrum cephalosporins. None of the isolates was resistant to imipenem. The bla(SHV5) gene was detected in 84% of isolates, followed by bla(CTX-M15) (27%), bla(SHV2) (9%), and bla(SHV12) (7%). PFGE identified six clones among the 28 ESBL-producing K. pneumoniae isolates. ESBL-producing K. pneumoniae clones were detected throughout the hospital. Use of broad-spectrum cephalosporins is the most important risk factor associated with the proliferation of ESBL-producing strains.

(PDF emailed within 0-6 h: $19.90)

Accession: 055579649

Download citation: RISBibTeXText

PMID: 22814216

DOI: 10.1159/000339483


Related references

Bloodstream infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary care hospital in New Zealand: risk factors and outcomes. International Journal of Infectious Diseases 16(5): E371-E374, 2013

The molecular and clinical epidemiology of enterobacteriaceae-producing extended-spectrum beta-lactamase in a tertiary care hospital. Journal of Infection 36(3): 279-285, 1998

Clinical epidemiology, risk factors and treatment outcomes of extended-spectrum beta-lactamase producing Enterobacteriaceae bacteremia among children in a Tertiary Care Hospital, Bangkok, Thailand. Bmc Research Notes 11(1): 624, 2018

Risk factors and prognosis of nosocomial bloodstream infections caused by extended-spectrum-beta-lactamase-producing Escherichia coli. Journal of Clinical Microbiology 48(5): 1726-1731, 2010

Risk factors for and mortality of extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections. Revista do Instituto de Medicina Tropical de Sao Paulo 51(4): 211-216, 2009

Molecular characterization of extended spectrum β-lactamase-producing Enterobacteriaceae strains isolated from a tertiary care hospital. Microbial Pathogenesis 115: 112-116, 2017

Bloodstream infections caused by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae: risk factors, molecular epidemiology, and clinical outcome. Antimicrobial Agents and ChemoTherapy 50(2): 498-504, 2006

Clinical features of nosocomial infections by extended-spectrum beta-lactamase-producing Enterobacteriaceae in neonatal intensive care units. Acta Paediatrica 94(11): 1644-1649, 2005

Risk factors and outcomes for bloodstream infections with extended-spectrum beta -lactamase-producing Klebsiella pneumoniae ; Findings of the nosocomial surveillance system in Hungary. Acta Microbiologica et Immunologica Hungarica 56(3): 251-262, 2009

Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae carriage at admission in an infant cohort at a tertiary teaching hospital in France. American Journal of Infection Control 41(9): 844-845, 2014

Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital. Journal of Hospital Infection 90(2): 102-107, 2016

The technical aspects and clinical significance of detecting extended-spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary-care hospital in Kuwait. Journal of ChemoTherapy 20(4): 445-451, 2008

Study of plasmid-mediated extended-spectrum β-lactamase-producing strains of enterobacteriaceae, isolated from diabetic foot infections in a North Indian tertiary-care hospital. Diabetes Technology and Therapeutics 14(4): 315-324, 2012

Epidemiology and Burden of Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae in a Pediatric Hospital in Senegal. Plos One 11(2): E0143729, 2016

Comparison Between Carbapenems and β-Lactam/β-Lactamase Inhibitors in the Treatment for Bloodstream Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae : A Systematic Review and Meta-Analysis. Open Forum Infectious Diseases 4(2): Ofx099, 2017