International Prospective Study of Klebsiella pneumoniae Bacteremia: Implications of Extended-Spectrum β-Lactamase Production in Nosocomial Infections

Paterson, David L.; Ko, Wen Chien; Gottberg, Anne von; Mohapatra, Sunlta; Casellas, José María; Goossens, Herman; Mülazımoğlu, Lütfiye; Trenholme, Gordon M.; Klugman, Keith; Rice, Louis B.; Wagener, Marilyn M.; McCormack, J. G.; Yu, Victor L.

doi:10.7326/0003-4819-140-1-200401060-00008

Cited by 551 publications

(389 citation statements)

References 23 publications

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“…7 Use of beta-lactam antibiotics containing an oxyimino group (cefuroxime, ceftriaxone, cefotaxime, ceftazidime, or aztreonam) are risk factors for ESBL-KP. [8][9][10][11] Nevertheless, time to use this group of drugs should not be guided by hospitalization length, because we could not correlate increased resistance with duration of hospitalization. Our institution will change the carbapenem restriction and assess the long term benefits of this approach in the mortality of patients with ESBL infection as well as the effect on resistance profile.…”

Section: Resultsmentioning

confidence: 99%

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Klebsiella ESBL bacteremia-mortality and risk factors

Tuon¹,

Kruger²,

Terreri³

et al. 2011

Braz J Infect Dis

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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.

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Section: Resultsmentioning

confidence: 99%

“…This risk factor had not been confirmed previously. 12,13 In our hospital, cefepime is commonly used for the treatment of severe community pneumonia at the emergency room. The use of cefepime is a modifiable risk factor, and restriction of cefepime use could be an approach to decrease ESBL-KP in our institution.…”

Section: Discussionmentioning

confidence: 99%

Klebsiella ESBL bacteremia-mortality and risk factors

Tuon¹,

Kruger²,

Terreri³

et al. 2011

Braz J Infect Dis

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show abstract

“…When we judged the complexity, we regarded the cases in which no follow‐up blood culture was performed as negative follow‐up blood cultures. We defined the cases that did not adhere to any of the three quality‐of‐care indicators as “non‐adherent patients.” We defined the other cases as “adherent patients.” The severity of disease was evaluated at the first positive blood culture, as determined using the Acute Physiology And Chronic Health Evaluation II (APACHE II) score and the Pitt bacteremia score 8. We collected data about the source of bacteremia from medical records.…”

Section: Methodsmentioning

confidence: 99%

Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

Miyamoto

Kato

Kitayama

et al. 2017

Acute Medicine & Surgery

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Aim Staphylococcus aureus bacteremia causes significant morbidity and mortality and requires specific management to prevent complications. Most studies evaluating quality of care have been carried out in Europe and North America, and accurate epidemiological data are lacking in Asia. We aimed to describe the epidemiology and evaluate the quality of care for S. aureus bacteremia in Japan.MethodsFrom February 2011 to January 2014, we undertook a multicenter retrospective observational study in 10 departments of emergency and critical care in Japan. We included 118 hospitalized adult patients with S. aureus bacteremia and evaluated three quality‐of‐care indicators: follow‐up blood culture, treatment duration, and echocardiography.ResultsThe mean age of the patients was 63.5 ± 17.0 years. The major source of bacteremia was pneumonia (n = 22, 19%), followed by skin and soft tissue infection (n = 18, 15%). Thirty patients (25%) died in the hospital. Follow‐up blood culture was performed in 21/112 patients (19%). The duration of antimicrobial treatment was sufficient in 49/87 patients (56%). Echocardiography for patients with clinical indication was undertaken in 39/59 patients (66%). Any of the three indicators were inadequate in 101/118 (86%).ConclusionThe rate of adequate care for S. aureus bacteremia is low in Japan. The low adherence rate for follow‐up blood culture was particularly notable. Staphylococcus aureus bacteremia can be an important target of quality improvement interventions.

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“…Initial clinical manifestation and Pitt bacteremia scores were defined as described elsewhere. 8,9 Identification and susceptibility testing of clinical isolates was performed using the MicroScan (Dade Behring, Newark, DE, USA) system.…”

Section: Methodsmentioning

confidence: 99%

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

Choi

Lee

Choi

et al. 2009

Journal of Infection

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International Prospective Study of Klebsiella pneumoniae Bacteremia: Implications of Extended-Spectrum β-Lactamase Production in Nosocomial Infections

Abstract: Production of ESBLs by Klebsiella pneumoniae is a widespread nosocomial problem. Appropriate infection control and antibiotic management strategies are needed to stem the spread of this emerging form of resistance.

Cited by 551 publications

References 23 publications

Klebsiella ESBL bacteremia-mortality and risk factors

Klebsiella ESBL bacteremia-mortality and risk factors

Adherence rate of quality‐of‐care indicators for Staphylococcus aureus bacteremia is extremely low in Japanese emergency and critical care departments: a multicenter retrospective observational study

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

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