Impact of Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae on the Outcome of Community-onset Bacteremic Urinary Tract Infections

Yang, Ya-Sung; Ku, Chih-Hung; Lin, Jung‐Chung; Shang, Shih-Ta; Chiu, Chong‐Chi; Yeh, Kuo-Ming; Lin, Chi-Kung; Chang, Feng–Yee

doi:10.1016/s1684-1182(10)60031-x

Cited by 66 publications

(45 citation statements)

References 16 publications

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“…Whether there is a survival difference in patients with good predicted prognosis (BSIMRS of Ͻ5) at initial presentation remains unclear. This may explain the lack of significant difference in mortality among patients with BSI who received appropriate and inappropriate empirical antimicrobial agents in prior studies, particularly when the majority of included patients had a urinary source of infection (13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Stratification of the Impact of Inappropriate Empirical Antimicrobial Therapy for Gram-Negative Bloodstream Infections by Predicted Prognosis

Cain

Kohn

Bookstaver

et al. 2015

Antimicrob Agents Chemother

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dThe bloodstream infection mortality risk score (BSIMRS) predicts the outcome of patients with Gram-negative bloodstream infections (BSI) with high discrimination. This retrospective cohort study examined the impact of inappropriate antimicrobial therapy on mortality in adult patients with Gram-negative BSI admitted to Palmetto Health Hospitals in Columbia, SC, USA, from 1 January 2011 to 31 December 2012 after stratification by predicted prognosis at initial presentation using BSIMRS. A multivariate Cox regression model was used to identify independent risk factors for 28-day mortality overall and within each predefined BSIMRS category (<5, 5 to 9, and >10). Relative risk reduction (RRR), absolute risk reduction (ARR), and number needed to treat (NNT) were calculated from a predictive logistic regression model of mortality. Overall, 390 unique patients with first episodes of Gram-negative BSI were identified. The median age was 66 years, and 229 (59%) were women. There was significant association between inappropriate antimicrobial therapy and mortality in patients with BSIMRS of 5 to 9 (adjusted hazard ratio

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Section: Discussionmentioning

confidence: 99%

Stratification of the Impact of Inappropriate Empirical Antimicrobial Therapy for Gram-Negative Bloodstream Infections by Predicted Prognosis

Cain

Kohn

Bookstaver

et al. 2015

Antimicrob Agents Chemother

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“…High levels of resistance to commonly used antibiotics have often been recorded among this group of bacteria worldwide [7,8]. In the last two decades, outbreaks of infections caused by extended-spectrum blactamase (ESBL)-producing Enterobacteriaceae have largely been reported [9,10].…”

Section: Introductionmentioning

confidence: 99%

The efficacy of some medicinal plants used locally within Transmara west, Narok County, Kenya against selected Enterobacteria and Candida

Nyang’au¹,

Maingi²,

Kebira³

2017

IOSRJPBS

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“…In fact, while several authors reported that age >65 years was predictor for ESBL infection, 13,14 others have not confirmed this. [15][16][17] In our study, 62% of patients were >60 years. Accordingly, age was not a risk factor, which could presumably be due to the selection bias.…”

Section: Discussionmentioning

confidence: 51%

Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

Bouassida¹,

Jaidane²,

Bouallègue³

et al. 2016

CUAJ

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Introduction: Our goal was to investigate the prevalence and antibiogram pattern of extended spectrum beta-lactamase (ESBL) production among uropathogens using isolates from urine samples collected at the Department of Urology in the Sahloul Hospital, Tunisia We also aimed to identify the risk factors for nosocomial urinary tract infections (UTIs) in patients who underwent transurethral resection of the prostate (TURP) and the measures for infection control. Methods: Laboratory records of a five-year period from January 2004 to December 2008 were submitted for retrospective analysis to determine the incidence of ESBL infections. A total of 276 isolates were collected. A case-control study involving comparisons between two groups of patients who underwent TURP was performed to determine the risk factors for ESBL infection. Group 1, designated case subjects, included 51 patients with nosocomial UTI after TURP. Group 2, designated control subjects, consisted of 58 randomly selected patients who underwent TURP without nosocomial UTI in the same period. Factors suspected to be implicated in the emergence of ESBL infection were compared between the two groups in order to identify risk factors for infection. A univariate regression analysis was performed, followed by a multivariate one. Results: The annual prevalence of ESBL infection ranged from 1.3-2.5%. After performing univariate and multivariate regression analysis, the main risk factors for ESBL infections were identified as: use of antibiotics the year preceding the admission, duration of catheter use, and bladder washout (p=0.012, p=0.019, and p<0.001. Conclusions: Urologists have to perform a good hemostasis, especially in endoscopic resections, in order to avoid bladder irrigation and bladder washout and to reduce the time of bladder catheterization, which is a strong risk factor of nosocomial UTIs. IntroductionHospital infections have become a growing healthcare challenge in recent decades and serious concerns have been expressed over the rise in antimicrobial resistance among pathogens causing hospital-acquired infections. Nosocomially acquired urinary tract infection (NAUTI) is one of the most common hospital-acquired infections. 2,3This infection is not already present or incubating at the time of admission, but is acquired during hospital stay. Its definition requires a 48-hour delay after admission before symptoms appear.1,4,5 NAUTI has become one of the most important quality parameters for urological surgery. The problem is further exacerbated by the emergence of drug resistance among uropathogens in the form of extended spectrum beta-lactamase (ESBL) production. In fact, the first outbreak of ESBL-producing organisms was reported in 1983 in Germany 1 and involved chromosomal-or plasmid-mediated beta-lactamases (enzymes that cleave the beta-lactam ring) that had mutated from pre-existing broad-spectrum beta-lactamases as a consequence of the extensive use of third-generation cephalosporins and aztreonam.6 Those ESBL-producing pathogens are now...

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Impact of Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae on the Outcome of Community-onset Bacteremic Urinary Tract Infections

Cited by 66 publications

References 16 publications

Stratification of the Impact of Inappropriate Empirical Antimicrobial Therapy for Gram-Negative Bloodstream Infections by Predicted Prognosis

Stratification of the Impact of Inappropriate Empirical Antimicrobial Therapy for Gram-Negative Bloodstream Infections by Predicted Prognosis

The efficacy of some medicinal plants used locally within Transmara west, Narok County, Kenya against selected Enterobacteria and Candida

Nosocomial urinary tract infections caused by extended-spectrum beta-lactamase uropathogens: Prevalence, pathogens, risk factors, and strategies for infection control

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