Risk Factors for Bloodstream Infections Due to ESBL-Producing Escherichia coli, Klebsiella spp., and Proteus mirabilis

Abstract

(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January 2019 to July 2021 and had positive blood cultures for E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis. Patients with ESBL infection were matched to a non-ESBL-producing infection with the same organism. (3) Results: A total of 150 patients were included: 50 in the ESBL group and 100 in the non-ESBL group. Patients in the ESBL group had a longer length of stay (11 vs. 7 days, p < 0.001), but not increased mortality (14% vs. 15%, p = 0.87) Multivariate analysis identified the receipt of >1 antibiotic in the last 90 days as a risk factor for ESBL infection (OR = 3.448, 95% CI = 1.494–7.957; p = 0.004); (4) Conclusions: Recent antimicrobial use was identified as an independent risk factors for ESBL-producing Enterobacterales infections. Knowledge of this risk may improve empirical therapy and reduce inappropriate use.

Evaluating the Impact of Source-specific Order Sets for Sepsis on Empiric Antibiotic Selection in the Emergency Department

“…Determination of appropriateness of MRSA and antipseudomonal coverage for bacterial pneumonia, urinary, intra-abdominal, and intravascular catheter sources was based on risk factors outlined in previously published guidelines [ 8–11 ]. ESBL coverage was considered appropriate if the patient had known colonization or infection within the past year or received broad-spectrum antibiotics within the past 90 days [ 12 ].…”

CTX-M, TEM, and SHV Genes in Escherichia coli, Klebsiella pneumoniae, and Enterobacter spp Isolated from Hematologic Cancer Patients with Bacteremia in Uganda

“…2 Among the organisms listed as the main cause of bacteremia are the extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), including E. coli, K. pneumoniae, Enterobacter spp., Citrobacter spp., and Proteus spp. [3][4][5][6][7][8] ESBL-PE are listed by the World Health Organization (WHO) in the critical group as one of the priority pathogens for research and development of new antibiotics. 9 The Centers for Disease Control and Prevention (CDC) has listed them as serious threats.…”

ESBL and carbapenemase-producing Enterobacteriaceae in infectious pleural effusions: current epidemiology at Hôpital du Mali

“…Data from recent studies found an association between extended-spectrum β-lactamases and carbapenemases producing Enterobacteriaceae (ESBL-E/CPE) infections and risk of mortality ( 12 , 13 ). Moreover, prior to antibiotherapy, comorbidities as well as persistent colonization were found to be strong predictors of infection and subsequent treatment failure ( 14 , 15 ). Yet to date, detailed reports on the magnitude of ESBL-E/CPE in West Africa are scarce ( 16 ).…”