Risk Factors for Colonization with Third–Generation Cephalosporin–Resistant Enterobacteriaceae

Abstract

Apart from the well-recognized risk factor previous antibiotic treatment, the risk factors age and presence of a CVC might suggest that bacterial overgrowth of the gut either due to an increased susceptibility in younger age or as a consequence of parenteral nutrition is a relevant mechanism for acquiring carriage of CRE in a non-outbreak situation.

Enterobacter Bacteremia: Clinical Features, Risk Factors for Multiresistance and Mortality in a Chinese University Hospital

“…The incidence of Enterobacter infection in hospital and the community has increased [14]. In recent years, Enterobacter especially with third-generation cephalosporin resistance has emerged as important nosocomial bacterial pathogens, which are closely associated with increased infection morbidity and mortality [15,16]. In our study overall nosocomial infection rate was 64.3% and nosocomial infection significantly affect the acquistion of the multiresistance and the outcome of the patients.…”

Epidemiological Interpretation of Studies Examining the Effect of Antibiotic Usage on Resistance

“…Studies may define their outcome as (i) the presence or absence of resistance to a given antibiotic, where the threshold for resistance can either include or exclude isolates with intermediate susceptibility to the chosen antibiotic (20,21); (ii) a change (e.g., 4-fold increase) in the MIC relative to the baseline MIC (22); or (iii) the specific mechanism that confers resistance (23,24). Study findings regarding the association between antibiotic use and resistance may vary depending on the definition chosen.…”

“…The second type of control group, patients uninfected with the resistant organism of interest, avoids the problem of overestimating the association between antibiotic exposure and resistance. A study by Fernandez et al (98) is an example of the minority of case-control studies with this design (20,(98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109). This study compared cases with ESBL-producing Enterobacter cloacae isolated in clinical cultures to controls who did not have ESBL-producing E. cloacae isolated.…”

149 Recommended initial antimicrobial therapy for emphysematous pyelonephritis: 51 cases and 14-year-experience of a tertiary referral center

“…Hence, empiric carbapenem treatment should be considered. As cited in other studies, 12,13 prior antibiotic treatment is a known risk factor for third-generation cephalosporin-resistant Enterobacteriaceae. Extended spectrum beta-lactamase (ESBL) producing or Amp-C harboring isolates should be considered.…”