Prevalence and impact of extended-spectrum beta-lactamase production on clinical outcomes in cancer patients with Enterobacter species bacteremia
The Korean Journal of Internal Medicine
; : 637-646, 2014.
Article
en En
| WPRIM
| ID: wpr-108337
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS: We examined the prevalence of extended-spectrum beta-lactamase (ESBL) production and the impact of ESBL on clinical outcomes in cancer patients with Enterobacter spp. bacteremia. METHODS: Using prospective cohort data on Enterobacter bacteremia obtained between January 2005 and November 2008 from a tertiary care center, the prevalence and clinical impact of ESBL production were evaluated. RESULTS: Two-hundred and three episodes of Enterobacter spp. bacteremia were identified. Thirty-one blood isolates (15.3%, 31/203) scored positive by the double-disk synergy test. Among 17 isolates in which ESBL genes were detected by polymerase chain reaction and sequencing, CTX-M (n = 12), SHV-12 (n = 11), and TEM (n = 4) were the most prevalent ESBL types. Prior usage of antimicrobial agents (77.4% vs. 54.0%, p = 0.02) and inappropriate empirical antimicrobial therapy (22.6% vs. 3.0%, p < 0.001) were more commonly encountered in the ESBL-positive group than in the extended-spectrum cephalosporin-susceptible ESBL-negative group, respectively. Clinical outcomes did not differ significantly between the two groups (30-day mortality rate, 19.4% vs. 17.0%, p = 0.76; median length of hospital stay, 24.0 days vs. 30.5 days, p = 0.97). Initial presentation of severe sepsis/septic shock, pneumonia, and intra-abdominal infection were independently associated with 30-day mortality. CONCLUSIONS: The prevalence of ESBL-producing isolates was 15.3% in cancer patients with Enterobacter bacteremia. Although inappropriate empirical therapy was more common in the ESBL-positive group, ESBL production was not associated with poorer outcomes.
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Texto completo:
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Índice:
WPRIM
Asunto principal:
Beta-Lactamasas
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Estudios Prospectivos
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Estudios de Cohortes
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Resultado del Tratamiento
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Bacteriemia
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Enterobacter
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Infecciones por Enterobacteriaceae
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Antibacterianos
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Neoplasias
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Child
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
The Korean Journal of Internal Medicine
Año:
2014
Tipo del documento:
Article