Clinical characteristics of bacteraemia caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in the era of CTX-M-type and KPC-type β-lactamases

Z. A. Qureshi, D. L. Paterson, A. Y. Peleg, J. M. Adams-Haduch, K. A. Shutt, D. L. Pakstis, E. Sordillo, B. Polsky, G. Sandkovsky, M. K. Bhussar, Yohei Doi

Research output: Contribution to journalArticle

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Abstract

Clin Microbiol Infect 2012; 18: 887-893 A multicentre, case-control study was conducted to assess risk factors and patient outcomes of bacteraemia caused by Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) and Klebsiella pneumoniae carbapenemases (KPCs). One hundred and five and 20 patients with bacteraemia caused by ESBL-producing and KPC-producing organisms were matched to controls who had bacteraemia caused by non-ESBL/KPC-producing organisms, respectively. Independent risk factors for ESBL production included admission from a nursing home (OR 4.64; 95% CI 2.64-8.16), chronic renal failure (OR 2.09; 95% CI 1.11-3.92), the presence of a gastrostomy tube (OR 3.36; 95% CI 1.38-8.18), length of hospital stay before infection (OR 1.02; 95% CI 1.01-1.03), transplant receipt (OR 2.48; 95% CI 1.24-4.95), and receipt of antibiotics with Gram-negative activity in the preceding 30 days (OR 1.76; 95% CI 1.00-3.08). Twenty-eight-day crude mortality rates for patients infected with ESBL-producing or KPC-producing organisms and controls were 29.1% (34/117) and 19.5% (53/272), respectively (OR 1.70; 95% CI 1.04-2.80). On multivariate analysis, inadequate empirical therapy (OR 2.26; 95% CI 1.18-4.34), onset of bacteraemia while in the intensive-care unit (OR 2.74; 95% CI 1.47-5.11), Apache II score (OR 1.17; 95% CI 1.12-1.23) and malignancy (OR 2.66; 95% CI 1.31-5.41) were independent risk factors for mortality. CTX-M was the most common ESBL type in Escherichia coli, whereas SHV predominated in Klebsiella spp. and Enterobacter spp.

Original languageEnglish
Pages (from-to)887-893
Number of pages7
JournalClinical Microbiology and Infection
Volume18
Issue number9
DOIs
Publication statusPublished - 01-01-2012
Externally publishedYes

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Klebsiella pneumoniae
Enterobacteriaceae
Bacteremia
Length of Stay
Enterobacter
Gastrostomy
Klebsiella
Mortality
Nursing Homes
Chronic Kidney Failure
Intensive Care Units
Case-Control Studies
Multivariate Analysis
Escherichia coli
Anti-Bacterial Agents
Transplants
Infection
Neoplasms
Therapeutics

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Qureshi, Z. A. ; Paterson, D. L. ; Peleg, A. Y. ; Adams-Haduch, J. M. ; Shutt, K. A. ; Pakstis, D. L. ; Sordillo, E. ; Polsky, B. ; Sandkovsky, G. ; Bhussar, M. K. ; Doi, Yohei. / Clinical characteristics of bacteraemia caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in the era of CTX-M-type and KPC-type β-lactamases. In: Clinical Microbiology and Infection. 2012 ; Vol. 18, No. 9. pp. 887-893.
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abstract = "Clin Microbiol Infect 2012; 18: 887-893 A multicentre, case-control study was conducted to assess risk factors and patient outcomes of bacteraemia caused by Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) and Klebsiella pneumoniae carbapenemases (KPCs). One hundred and five and 20 patients with bacteraemia caused by ESBL-producing and KPC-producing organisms were matched to controls who had bacteraemia caused by non-ESBL/KPC-producing organisms, respectively. Independent risk factors for ESBL production included admission from a nursing home (OR 4.64; 95{\%} CI 2.64-8.16), chronic renal failure (OR 2.09; 95{\%} CI 1.11-3.92), the presence of a gastrostomy tube (OR 3.36; 95{\%} CI 1.38-8.18), length of hospital stay before infection (OR 1.02; 95{\%} CI 1.01-1.03), transplant receipt (OR 2.48; 95{\%} CI 1.24-4.95), and receipt of antibiotics with Gram-negative activity in the preceding 30 days (OR 1.76; 95{\%} CI 1.00-3.08). Twenty-eight-day crude mortality rates for patients infected with ESBL-producing or KPC-producing organisms and controls were 29.1{\%} (34/117) and 19.5{\%} (53/272), respectively (OR 1.70; 95{\%} CI 1.04-2.80). On multivariate analysis, inadequate empirical therapy (OR 2.26; 95{\%} CI 1.18-4.34), onset of bacteraemia while in the intensive-care unit (OR 2.74; 95{\%} CI 1.47-5.11), Apache II score (OR 1.17; 95{\%} CI 1.12-1.23) and malignancy (OR 2.66; 95{\%} CI 1.31-5.41) were independent risk factors for mortality. CTX-M was the most common ESBL type in Escherichia coli, whereas SHV predominated in Klebsiella spp. and Enterobacter spp.",
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Qureshi, ZA, Paterson, DL, Peleg, AY, Adams-Haduch, JM, Shutt, KA, Pakstis, DL, Sordillo, E, Polsky, B, Sandkovsky, G, Bhussar, MK & Doi, Y 2012, 'Clinical characteristics of bacteraemia caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in the era of CTX-M-type and KPC-type β-lactamases', Clinical Microbiology and Infection, vol. 18, no. 9, pp. 887-893. https://doi.org/10.1111/j.1469-0691.2011.03658.x

Clinical characteristics of bacteraemia caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in the era of CTX-M-type and KPC-type β-lactamases. / Qureshi, Z. A.; Paterson, D. L.; Peleg, A. Y.; Adams-Haduch, J. M.; Shutt, K. A.; Pakstis, D. L.; Sordillo, E.; Polsky, B.; Sandkovsky, G.; Bhussar, M. K.; Doi, Yohei.

In: Clinical Microbiology and Infection, Vol. 18, No. 9, 01.01.2012, p. 887-893.

Research output: Contribution to journalArticle

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AU - Sordillo, E.

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