+ 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 for and mortality of extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections



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



A case-control study, involving patients with positive blood cultures for Klebsiella pneumoniae (KP) or Escherichia coli (EC) EC and controls with positive blood cultures for non-ESBL-KP or EC, was performed to assess risk factors for extended-spectrum-beta-lactamase (ESBL) production from nosocomial bloodstream infections (BSIs). Mortality among patients with BSIs was also assessed. The study included 145 patients (81, 59.5% with K. pneumoniae and 64, 44.1% with E. coli BSI); 51 (35.2%) isolates were ESBL producers and 94 (64.8%) nonproducers. Forty-five (55.6%) K. pneumoniae isolates were ESBL producers, while only six (9.4%) E. coli isolates produced the enzyme. Multivariate analysis showed that recent exposure to piperacillin-tazobactam (adjusted Odds Ratio [aOR] 6.2; 95%CI 1.1-34.7) was a risk factor for ESBL BSI. K. pneumoniae was significantly more likely to be an ESBL-producing isolate than E. coli (aOR 6.7; 95%CI 2.3-20.2). No cephalosporin class was independently associated with ESBLs BSI; however, in a secondary model considering all oxymino-cephalosporins as a single variable, a significant association was demonstrated (aOR 3.7; 95%CI 1.3-10.8). Overall 60-day mortality was significantly higher among ESBL-producing organisms. The finding that piperacillin-tazobactam use is a risk factor for ESBL-production in KP or EC BSIs requires attention, since this drug can be recommended to limit the use of third-generation cephalosporins.

(PDF emailed within 1 workday: $29.90)

Accession: 055580325

Download citation: RISBibTeXText

PMID: 19739001


Related references

Bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae: risk factors for mortality and treatment outcome, with special emphasis on antimicrobial therapy. Antimicrobial Agents and ChemoTherapy 48(12): 4574-4581, 2004

Bloodstream infections due to extended spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae Risk factors for mortality and clinical outcome, with special emphasis on antimicrobial therapy. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 43: 364, 2003

Risk Factors for Ciprofloxacin Resistance in Bloodstream Infections Due to Extended-Spectrum beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae. Microbial Drug Resistance 10(1): 71-76, 2004

Risk factors for ciprofloxacin resistance in bloodstream infections due to extended-spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae. Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 43: 365, 2003

Predictors of mortality from community-onset bloodstream infections due to extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Infection Control and Hospital Epidemiology 29(7): 671-674, 2008

Risk factors for bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Brazilian Journal of Infectious Diseases 15(4): 370-376, 2012

Risk factors for bloodstream infections caused by extended-spectrum ?-lactamase-producing Escherichia coli and Klebsiella pneumoniae. The Brazilian Journal of Infectious Diseases 15(4): 370-376, 2011

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

Impact of Cefepime Therapy on Mortality among Patients with Bloodstream Infections Caused by Extended-Spectrum-beta-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli. 2012

Risk factors and prognosis in 31 patients with extended-spectrum beta-lactamase producing Escherichia coli and Klebsiella pneumoniae bloodstream infection. Zhonghua Jie He He Hu Xi Za Zhi 31(11): 815-819, 2010

Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae bloodstream infection: risk factors and clinical outcome. Intensive Care Medicine 28(12): 1718-1723, 2002

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

Fluoroquinolone therapy for bloodstream infections caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Journal of Microbiology, Immunology, and Infection 50(3): 355-361, 2015

Risk factors for the emergence of fluoroquinolone resistance in infections due to extended-spectrum beta-lactamase -producing Escherichia coli and Klebsiella pneumoniae. Clinical Infectious Diseases 31(1): 212, 2000

Impact of cefepime therapy on mortality among patients with bloodstream infections caused by extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli. Antimicrobial Agents and ChemoTherapy 56(7): 3936-3942, 2012