Klebsiella ESBL bacteremia-mortality and risk factors

Abstract

Background: Extended spectrum β-lactamase (ESBL)-producing bacteria have become recognized as a problem in South America. The aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by ESBL-producing Klebsiella pneumoniae in a Brazilian hospital. Methods: A three-year retrospective cohort study with 104 cases of K. pneumoniae bacteremia (61 ESBL and 43 non-ESBL). Several clinical and laboratory variables were evaluated. The outcome of interest was 30-day mortality. The adequate treatment was evaluated according to antibiotic susceptibility. Results: Multivariable analysis showed that central venous catheter and mechanical ventilation were independent risk factors for ESBL. The duration of hospitalization before the bacteremia was not a risk factor. Mortality was similar in ESBL and non-ESBL and inadequate therapy was not shown to be a risk factor. Conclusion: ESBL-producing Klebsiella bacteremia can occur early, suggesting that a carbapenem should be included in the initial empirical therapy for bacteremia in patients under mechanical ventilation and/or central venous catheter in our institution.

Occurrence and sensitivity profile of extended spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary hospital in Southern Brazil

“…The main risk factors for colonization by ESBL-producing isolates include invasive procedures such as use of a central venous line or arterial catheter, length of hospital stay (especially in ICUs), urinary catheter, mechanical ventilation, severity of disease, and previous exposure to antibiotics (4) (17) . The highest incidence of ESBL-producing bacteria was found in the wards, especially in the ICU/N.…”

RESISTENSI <em>Klebsiella</em> sp TERHADAP MEROPENEM DI RSUD PROF. DR. MARGONO SOEKARJO PURWOKERTO

“…Hal ini berbahaya karena dapat meningkatkan risiko terjadinya infeksi saluran kemih, pyelonephritis dan sepsis sehingga akan meningkatkan morbiditas serta mortalitas (Widodo, 2010;Peleg & Hooper, 2010;Purnomo, 2008). Meningkatnya mortalitas berkaitan dengan terapi antibiotik yang tidak tepat terhadap bakteri penghasil ESBL (Tuon et al, 2011 (Cockeril et al, 2010).…”

Detection of High Prevalence of TEM/SHV/CTX-M Genes in ESBL Producing and Multidrug Resistant Klebsiella Pneumoniae and Klebsiella Oxytoca

“…The first reported β-lactamases TEM-1/2 and SHV-1, described since 1960 from E. coli and Klebsiella pneumoniae were usually chromosomal. They are the most medically important species, often isolated from severe infections in hospitalized or ambulatory patients [25][26][27][28][29]. Klebsiella spp.…”

“…with variation from one continent to another. The global multi-center surveillance study Tigecycline Evaluation and Surveillance Trial (TEST) reported from 2004 to 2009 an overall prevalence of ESBL producing Klebsiella pneumoniae isolated from intensive care units (ICUs), ranging from 12.8% in North America to 26.6% in Europe, 33.8% in the Middle East, 35.6% in the Asia-Pacific region, 45.5% in Latin America an up to 54.9% in Africa [33]. In addition, Hoban et al reported a prevalence of ESBL of 8.8% and 38.9% in North America and Europe respectively with a predominance of CTX-M15 subgroup [34] on Klebsiella pneumoniae strains isolated from urinary tract infections.…”