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Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella spp. infection among hospitalized patients
Bellíssimo-Rodrigues, Fernando; Gomes, Ana Carolina Frade; Passos, Afonso Dinis Costa; Achcar, Jorge Alberto; Perdoná, Gleici da Silva Castro; Martinez, Roberto.
  • Bellíssimo-Rodrigues, Fernando; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Comisão de Controle de Infecção Hospitalar. Ribeirão Preto. BR
  • Gomes, Ana Carolina Frade; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Laboratório de Microbiologia. Ribeirão Preto. BR
  • Passos, Afonso Dinis Costa; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Departamento de Medicina Social. Ribeirão Preto. BR
  • Achcar, Jorge Alberto; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Departamento de Medicina Social. Ribeirão Preto. BR
  • Perdoná, Gleici da Silva Castro; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Departamento de Medicina Social. Ribeirão Preto. BR
  • Martinez, Roberto; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Hospital das Clínicas. Departamento de Clínica Médica. Ribeirão Preto. BR
Mem. Inst. Oswaldo Cruz ; 101(4): 415-421, June 2006. tab
Article in English | LILACS | ID: lil-435303
ABSTRACT
Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives wereto evaluate among in-patients at a publicuniversity tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables withindependent association withdeath detected in this investigation.
Subject(s)
Full text: Available Index: LILACS (Americas) Main subject: Beta-Lactamases / Klebsiella Infections / Cross Infection / Klebsiella Type of study: Etiology study / Risk factors Limits: Female / Humans / Male Language: English Journal: Mem. Inst. Oswaldo Cruz Journal subject: Tropical Medicine / Parasitology Year: 2006 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Beta-Lactamases / Klebsiella Infections / Cross Infection / Klebsiella Type of study: Etiology study / Risk factors Limits: Female / Humans / Male Language: English Journal: Mem. Inst. Oswaldo Cruz Journal subject: Tropical Medicine / Parasitology Year: 2006 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR