Risk Factors for and Clinical Outcomes of Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae

Abstract

For K. pneumoniae bacteremia, patients with ESBL-KP had a higher initial treatment failure rate but did not have higher mortality if antimicrobial therapy was appropriately adjusted in this study with limited statistical power.

Prevalence, Treatment, and Outcome of Infection Due to Extended-Spectrumβ-Lactamase–Producing Microorganisms

“…1,5 " 7 Given the high prevalence and associated crude mortality rate associated with ESBL-producing E. coli and K. pneumoniae BSIs in our study, tertiary care centers in Thailand should consider routine screening of E. coli and K. pneumoniae isolates for ESBL production. Although the small sample size limits our ability to quantify the true risk associated with ineffective antimicrobial therapy or to identify additional factors that may be associated with mortality, our data further substantiate the findings by Kang et al 1 and suggest that initial empirical antimicrobial therapy that is ineffective may not be associated with higher mortality rates for nosocomial BSI caused by ESBL-producing E. coli or K. pneumoniae. Additional studies on the prevalence, treatment, and role of ineffective antimicrobial therapy on the outcomes for persons infected with ESBL-producing E. coli or K. pneumoniae in Asian-Pacific countries are needed.…”

“…Prevalence, Treatment, and Outcome of Infection Due to Extended-Spectrum /3-Lactamase-Producing Microorganisms TO T H E E D I T O R -W e read with interest the article by Kang et al 1 and would like to report the prevalence, treatment, and outcome of nosocomial infections caused by extended-spectrum /3-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care center in Thailand. At Thammasart University Hospital (Pratumthani, Thailand), routine laboratory-based detection and confirmation of ESBL-producing E. coli and K. for nosocomial infections were used in the diagnosis of all infections.…”

Prevalence and risk factors of extended-spectrum β-lactamases producing Enterobacteriaceae in a general hospital in Saudi Arabia

“…Antimicrobial exposure is considered to be an important risk factor for ESBL related infections as it allows resistant mutants to become the dominant strains. [26][27][28] Cephalosporin and fluoroquinolone exposure was reported as risk factor for multidrug resistant bacteria infections, previously.…”

Risk factors for bloodstream infections caused by extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae

“…15 In a retrospective case-control study in patients with K. pneumoniae bacteremia, for the addition of each antimicrobial agent, an increase of 1.55 in the risk of ESBL-producing K. pneumoniae strains was observed. 16 Although a large number of studies included in their objectives to assess the association between use of antibiotics and the emergence of resistance, the systems used to define the prior use of antimicrobials have not been properly Risk factors for bloodstream infections caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae described. Thus, the selection of one or other method of categorization can lead to the identification of different risk factors.…”

“…17 For this reason, it is important to clarify these issues for the design of strategies aimed at reducing resistances. Other variables associated with the identification of ESBL-producing strains in patients with bloodstream infection reported in the literature are the patient's age, 15 severe underlying diseases, 13 renal transplantation, 13 previous admission to the ICU, 18 duration of hospitalization before bacteremia, 19 prior exposure to urinary catheters, 10,14,16 invasive procedure within the previous 72 hours, 16 and the nosocomial origin of bacteremia. 10 In a systematic review of studies evaluating the association between inappropriate antibiotic therapy and mortality among bacteremic patients, measurement of severity of illness without specified the time at which it was measured was considered a source of methodological heterogeneity that may explain conflicting findings.…”