Factores de riesgo asociados a infecciones por Klebsiella pneumoniae resistentes a ceftacidima

Bermejo, Joaquín; Lesnaberes, Patricia; Arnesi, Nora; Gianello, Mariano; Notario, Rodolfo; Borda, Noemí; Gambandé, Telma; Bencomo, Blanca

doi:10.1157/13042862

Cited by 6 publications

(7 citation statements)

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“…In the acute-care setting, similar risk factors for the acquisition of broad-spectrum cephalosporin-resistant Enterobacteriaceae have been recognized ( 15 – 19 ). The risk of acquiring multidrug-resistant bacterial infection has been reported as increasing in hospitalized patients with prior third-generation cephalosporin therapy ( 6 , 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…Prior antimicrobial drug use was associated with acquisition of this type of resistant infection [adjusted OR 6.21, 95% CI 1.20 to 32.01]. Other risk factors found were prior use of ciprofloxacin, nosocomial infection, and hospitalization stay >6 days ( 15 ). Bisson et al also looked at risk factors for acquisition of ESBL-producing Klebsiella spp.…”

Section: Discussionmentioning

confidence: 99%

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Nursing Home Residents andEnterobacteriaceaeResistant to Third-Generation Cephalosporins

Sandoval

Walter

McGeer

et al. 2004

Emerg. Infect. Dis.

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Limited data identify the risk factors for infection with Enterobacteriaceae resistant to third-generation cephalosporins among residents of long-term-care facilities. Using a nested case-control study design, nursing home residents with clinical isolates of Enterobacteriaceae resistant to third-generation cephalosporins were compared to residents with isolates of Enterobacteriaceae susceptible to third-generation cephalosporins. Data were collected on antimicrobial drug exposure 10 weeks before detection of the isolates, facility-level demographics, hygiene facilities, and staffing levels. Logistic regression models were built to adjust for confounding variables. Twenty-seven case-residents were identified and compared to 85 controls. Exposure to any cephalosporin (adjusted odds ratio [OR] 4.0, 95% confidence interval [CI] 1.2 to13.6) and log percentage of residents using gastrostomy tubes within the nursing home (adjusted OR 3.9, 95% CI 1.3 to 12.0) were associated with having a clinical isolate resistant to third-generation cephalosporins.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nursing Home Residents andEnterobacteriaceaeResistant to Third-Generation Cephalosporins

Sandoval

Walter

McGeer

et al. 2004

Emerg. Infect. Dis.

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“…The literature is conflictive about this effect. Kim et al (2002), Bermejo et al (2003), and Lupi et al (2004) reported a higher mortality rate among patients infected with an ESBL-producing K. pneumoniae, compared to those infected by non-ESBL-producing strains, but they did not use multivariate analysis. In contrast, Menashe et al (2001) and Kang et al (2004), analyzing bloodstream infections caused by ESBL-producing and non-ESBL-producing Enterobacteriaceae, found a similar mortality rate for the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…compared to non-ESBL-producing Klebsiella spp., with some studies reporting a negative impact (Paterson et al 1997, Kim et al 2002, Bermejo et al 2003, Martínez et al 2005 and others finding no impact (Menashe et al 2001, Kang et al 2004.…”

mentioning

confidence: 98%

“…infections have been described, the most frequent being antimicrobial exposure, especially to third-generation cephalosporins (Naumovski et al 1992, Lautenbach et al 2001, Bermejo et al 2003, and exposure to invasive procedures such as central venous catheters, mechanical ventilation, urinary catheterization and intraabdominal surgery (Piroth et al 1998, Lautenbach et al 2001, Menashe et al 2001). It has also been demonstrated that this kind of infection increases length of stay among hospitalized patients (Cofsky et al 2002, Stone et al 2003, producing a significant economic impact (Stone et al 2003).…”

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confidence: 99%

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Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients

Bellissimo-Rodrigues

Gomes

Passos

et al. 2006

Mem. Inst. Oswaldo Cruz

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Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producingOver the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world (CDC 1998, Archibald 2004, Martins et al. 2005). This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens (Bratu et al. 2005), and also because this kind of resistance can spread to a wide variety of Gramnegative bacilli, either Enterobacteriaceae (Knothe et al. 1983, Chanawong et al. 2001, Petroni et al. 2002, Calatayud 2005 or non-fermentative microorganisms (Poirel et al. 2003, Quinteros et al. 2003.Several risk factors for ESBL-producing Klebsiella spp. infections have been described, the most frequent being antimicrobial exposure, especially to third-generation cephalosporins (Naumovski et al. 1992, Lautenbach et al. 2001, Bermejo et al. 2003, and exposure to invasive procedures such as central venous catheters, mechanical ventilation, urinary catheterization and intraabdominal surgery (Piroth et al. 1998, Lautenbach et al. 2001, Menashe et al. 2001). It has also been demonstrated that this kind of infection increases length of stay among hospitalized patients (Cofsky et al. 2002, Stone et al. 2003, producing a significant economic impact (Stone et al. 2003).The literature is conflictive about the effect on mortality caused by ESBL-producing Klebsiella spp. compared to non-ESBL-producing Klebsiella spp., with some studies reporting a negative impact (Paterson et al. 1997, Kim et al. 2002, Bermejo et al. 2003, Martínez et al. 2005 and others finding no impact (Menashe et al. 2001, Kang et al. 2004.The purpose of the present study was to assess the risk factors and clinical impact associated with ESBL-producing strains, compared to non-ESBL-producing strains among in-patients at a university hospital with documented infection caused by Klebsiella spp. MATERIALS AND METHODSThe University Hospital of the Faculty of Medicine of Ribeirão Preto (HC-FMRP) is a general hospital located in Ribeirão Preto city, at the state of São Paulo. It has 847-bes, distributed in 29 wards with several clinical and surgical specialties. It has six intensive-care units, being their areas of activities: neonatology, pediatry, general care of adults, cardiology, thoracic surgery, and neurosurgery.The research project was submitted to the local Ethics Committee and was approved. 2003). We considered the E-test  to be positive when it showed at least a 4-fold decrease in the MIC for the combination side, compared to the cephalosporin alone side (NCCLS 2000). Strains were considered to be ESBL-producers when they tested positive in at least one detection test. K. pneumoniae ATCC 700603 was used as a positive control and E. coli ATCC 25922 as a negative control for the ESBL detection tests.Clinical data were collected from the medical records and also from physical examination of the patients...

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Implicaciones de las resistencias bacterianas en las infecciones urinarias adquiridas en la comunidad

Horcajada

Fariñas

2005

Enfermedades Infecciosas y Microbiología Clínica

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Factores de riesgo asociados a infecciones por Klebsiella pneumoniae resistentes a ceftacidima

Cited by 6 publications

References 0 publications

Nursing Home Residents andEnterobacteriaceaeResistant to Third-Generation Cephalosporins

Nursing Home Residents andEnterobacteriaceaeResistant to Third-Generation Cephalosporins

Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients

Implicaciones de las resistencias bacterianas en las infecciones urinarias adquiridas en la comunidad

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