Bloodstream infections caused by ESBL-producing E. Coli and K. pneumoniae: risk factors for multidrug-resistance

Abstract

to evaluate risk factors for multidrug resistance among extended-spectrum-b-lactamase-producing Escherichia coli and Klebsiella spp. (ESBL-EK) isolates in blood cultures. All adult patients (≥18 years old) whose blood cultures grew ESBL-EK during the study period were included. An ESBL-EK isolate was defined as MDR if it was resistant to at least one member of following two classes of antibiotics: aminoglycosides (amikacin, gentamicin, or netilmycin) and fluoroquinolones (ofloxacin, or ciprofloxacin). Case patients were those with a MDR ESBL-EK isolate, and control patients were those with a non-MDR ESBL-EK isolate. A total of 94 bloodstream infections, including 37 (39,4%) bloodstream infections with ESBL-producing E. coli and 57 (60,6%) with ESBL-producing K. pneumoniae, in 86 patients were enrolled. Thirty episodes (31.9%) were due to MDR ESBL-EK. The only independent risk factor for MDR ESBL-EK was duration of hospitalization before bacteraemia (OR 3.88; 95% CI 1.55-9.71; p=0.004). The rate of multidrug resistance among ESBL-EK bloodstream isolates was high, and duration of hospitalization before bacteraemia was the only indeepended risk factor for the MDR ESBL-EK bloodstream infections.

Prevalence, Genotyping of Escherichia coli and Pseudomonas aeruginosa Clinical Isolates for Oxacillinase Resistance and Mapping Susceptibility Behaviour

“…Table 2 demonstrates distribution of the isolates in terms of sample sources. This shows that maximum E. coli isolates were recovered from tracheal aspirates (36) followed by urine (24), blood (22) and pus (16). For P. aeruginosa the greatest number of isolates were identified from pus (54) followed by tracheal aspirates (42) wound (28) and blood (24).…”

Characteristics of Extended-Spectrum β-Lactamases-Producing <i>Escherichia coli</i> in Fecal Samples of Inpatients of Beijing Tongren Hospital

“…The prevalence of ESBLs among clinically relevant strains varies from year to year, region to region, and even among hospitals within the same community (3). It has been reported that the ESBL prevalence is higher in Europe than in the USA but lower in Asia or South America (4). Sequence type (ST) 131 is the most common genotype of ES-BL-producing E. coli, and 54.2% of community-associated infections are caused by the ST131 strain (5,6).…”

Risk factors for bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae

“…17 For this reason, it is important to clarify these issues for the design of strategies aimed at reducing resistances. Other variables associated with the identification of ESBL-producing strains in patients with bloodstream infection reported in the literature are the patient's age, 15 severe underlying diseases, 13 renal transplantation, 13 previous admission to the ICU, 18 duration of hospitalization before bacteremia, 19 prior exposure to urinary catheters, 10,14,16 invasive procedure within the previous 72 hours, 16 and the nosocomial origin of bacteremia. 10 In a systematic review of studies evaluating the association between inappropriate antibiotic therapy and mortality among bacteremic patients, measurement of severity of illness without specified the time at which it was measured was considered a source of methodological heterogeneity that may explain conflicting findings.…”