Differences in mortality between infections due to extended-spectrum-beta-lactamase–producing <i>Klebsiella pneumoniae</i> and <i>Escherichia coli</i>

Burnham, Jason P.; Kwon, Jennie H.; Olsen, Margaret A.; Babcock, Hilary M.; Kollef, Marin H.

doi:10.1017/ice.2018.142

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…This observation hints at specific virulence factors making K. pneumoniae much harder to eradicate than E. coli. This finding is in line with two reports that studied the differences in terms of outcomes between infections due to ESBL-producing K. pneumoniae and E. coli [19,20]. They showed a trend towards a higher mortality amongst ESBL-producing K. pneumoniae-infected patients in systemic infections.…”

Section: Discussionsupporting

confidence: 92%

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area

Saleh‐Mghir¹,

Rottman²,

Jaffal³

et al. 2022

International Journal of Antimicrobial Agents

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Section: Discussionsupporting

confidence: 92%

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area

Saleh‐Mghir¹,

Rottman²,

Jaffal³

et al. 2022

International Journal of Antimicrobial Agents

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“…All analyses confirmed an independently increased risk of ESBL-KP infection after rectal colonization with this pathogen. Burnham et al found similar effects on hospital mortality, but also showed that sufficiently powered studies and competing risk analyses are necessary to prove this effect [21].…”

Section: Discussionmentioning

confidence: 89%

Infections caused by extended-spectrum β-lactamase-producing Enterobacterales after rectal colonization with ESBL-producing Escherichia coli or Klebsiella pneumoniae

Denkel

Maechler

Schwab

et al. 2020

Clinical Microbiology and Infection

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Healthcare-associated infections Klebsiella pneumoniae a b s t r a c t Objectives: Infections as a result of extended-spectrum b-lactamase-producing Enterobacterales (ESBL-E) are considered infections with a high public health burden. In this study, we aimed to identify incidences of and risk factors for healthcare-associated infections (HAIs) after rectal colonization with ESBLproducing Escherichia coli (ESBL-EC) or Klebsiella pneumoniae (ESBL-KP). Methods: This prospective cohort study was performed in 2014 and 2015. Patients colonized with ESBL-EC or ESBL-KP were monitored for subsequent HAI with ESBL-E and other pathogens. In the case of an ESBL-E infection, rectal and clinical isolates were compared using pulsed-field gel electrophoresis (PFGE), and whole-genome sequencing (WGS) for ESBL-KP isolates. Proportional hazard models were applied to identify risk factors for HAIs, and to analyse competing risks. Results: Among all patients admitted to the hospital during the study period, 13.6% were rectally screened for third-generation cephalosporin-resistant Enterobacterales (3GCREB). A total of 2386 rectal carriers of ESBL-EC and 585 of ESBL-KP were included in the study. Incidence density (ID) for HAI with ESBL-E was 2.74 per 1000 patient days at risk (95% confidence interval (CI) 2.16e3.43) among carriers of ESBL-EC, while it was 4.44 per 1000 patient days at risk (95% CI 3.17e6.04) among carriers of ESBL-KP. In contrast, ID for HAI with other pathogens was 4.36 per 1000 patient days at risk (95% CI 3.62e5.21) among carriers of ESBL-EC, and 5.00 per 1000 patient days at risk (95% CI 3.64e6.69) among carriers of ESBL-KP. Cox proportional hazard regression analyses identified colonization with ESBL-KP (HR ¼ 1.58, 95% CI 1.068e2.325) compared with ESBL-EC as independent risk factor for HAI with ESBL-E. The results were consistent over all competing risk analyses. Conclusions: Clinicians should be aware of the increased risk of ESBL-E infections among patients colonized with ESBL-KP compared with ESBL-EC that might be caused by underlying diseases, higher pathogenicity of ESBL-KP and other factors.

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“…was associated with bacteremia recurrence, relative to isolation of E. coli and after adjustment. Other work has suggested that patients with ESBL-producing Klebsiella pneumoniae bacteremia have higher rates of ICU admission and death compared with patients with ESBL-producing E. coli bacteremia ( 30 , 31 ). Overall, our findings demonstrate a new facet to the disease burden imposed by 3GC resistance in E. coli and especially Klebsiella spp.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance as Risk Factor for Recurrent Bacteremia after Staphylococcusaureus, Escherichia coli, or Klebsiella spp. Community-Onset Bacteremia

Abbara,

Guillemot,

Smith

et al. 2024

Emerg. Infect. Dis.

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We investigated links between antimicrobial resistance in community-onset bacteremia and 1-year bacteremia recurrence by using the clinical data warehouse of Europe’s largest university hospital group in France. We included adult patients hospitalized with an incident community-onset Staphylococcus aureus , Escherichia coli , or Klebsiella spp. bacteremia during 2017–2019. We assessed risk factors of 1-year recurrence using Fine–Gray regression models. Of the 3,617 patients included, 291 (8.0%) had > 1 recurrence episode. Third-generation cephalosporin (3GC)-resistance was significantly associated with increased recurrence risk after incident Klebsiella spp. (hazard ratio 3.91 [95% CI 2.32–6.59]) or E. coli (hazard ratio 2.35 [95% CI 1.50–3.68]) bacteremia. Methicillin resistance in S. aureus bacteremia had no effect on recurrence risk. Although several underlying conditions and infection sources increased recurrence risk, 3GC-resistant Klebsiella spp. was associated with the greatest increase. These results demonstrate a new facet to illness induced by 3GC-resistant Klebsiella spp. and E. coli in the community setting.

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Differences in mortality between infections due to extended-spectrum-beta-lactamase–producing Klebsiella pneumoniae and Escherichia coli

Cited by 4 publications

References 5 publications

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area

Native bone and joint infections caused by extended-spectrum β-lactamase-producing Enterobacterales: experience of a reference centre in the Greater Paris area

Infections caused by extended-spectrum β-lactamase-producing Enterobacterales after rectal colonization with ESBL-producing Escherichia coli or Klebsiella pneumoniae

Antimicrobial Resistance as Risk Factor for Recurrent Bacteremia after Staphylococcusaureus, Escherichia coli, or Klebsiella spp. Community-Onset Bacteremia

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