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Enterobacteriaceae resistant to third generation cephalosporins upon hospital admission: risk factors and clinical outcomes
Oliveira, Mirian Cristina; Oliveira, Clara Rodrigues Alves; Gonçalves, Karine Valéria; Santos, Marciléa Silva; Tardelli, Amanda Cristina Silva; Nobre Jr., Vandack Alencar.
  • Oliveira, Mirian Cristina; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
  • Oliveira, Clara Rodrigues Alves; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
  • Gonçalves, Karine Valéria; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
  • Santos, Marciléa Silva; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
  • Tardelli, Amanda Cristina Silva; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
  • Nobre Jr., Vandack Alencar; Universidade Federal de Minas Gerais. School of Medicine. Internal Medicine Department. Belo Horizonte. BR
Braz. j. infect. dis ; 19(3): 239-245, May-Jun/2015. tab, graf
Article Dans Anglais | LILACS | ID: lil-751890
ABSTRACT

Objectives:

Evaluate risk factors and clinical outcomes of infections caused by Enterobacteriaceae resistant to third-generation cephalosporins present in samples collected upon hospital admission.

Methods:

Risk factors were evaluated using a 12 ratio case-control study. Influence of resistance on the appropriateness of antibiotic therapy, length of stay, and hospital mortality were prospectively evaluated. Characteristics independently associated with the presence of resistant enterobacteria were assessed by logistic regression.

Results:

Enterobacteria resistant to third-generation cephalosporins were quite common (26.0%). Male gender (OR 2.66; 95% CI, 1.17-5.06; p = 0.019), invasive prosthesis (OR 3.79; 95% CI, 1.29-11.08; p = 0.015), previous use of cephalosporins (OR 2.77; 95% CI, 1.10-6.97; p = 0.029) and hospitalization in the last 6 months (OR 5.33; 95% CI, 2.29-12.44; p < 0.001) were independently associated with the presence of these microorganisms. These bacteria were associated with higher frequency of inappropriate antimicrobial therapy, worse clinical response, and longer length of stay. Finally, older age, admission to the ICU, and site of infection other than urinary tract were independently associated to higher hospital mortality.

Conclusions:

Risk factors identified in this study may help in the choice of empirical antibiotic therapy for infected patients suspected of harboring these bacteria and in the early implementation of measures to avoid the spread of these bacteria in the hospital environment. .
Sujets)


Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Céphalosporines / Résistance aux céphalosporines / Enterobacteriaceae / Infections à Enterobacteriaceae / Antibactériens Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains / Mâle langue: Anglais Texte intégral: Braz. j. infect. dis Thème du journal: Maladies transmissibles Année: 2015 Type: Article / descriptif de projet Pays d'affiliation: Brésil Institution/Pays d'affiliation: Universidade Federal de Minas Gerais/BR

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Céphalosporines / Résistance aux céphalosporines / Enterobacteriaceae / Infections à Enterobacteriaceae / Antibactériens Type d'étude: Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Femelle / Humains / Mâle langue: Anglais Texte intégral: Braz. j. infect. dis Thème du journal: Maladies transmissibles Année: 2015 Type: Article / descriptif de projet Pays d'affiliation: Brésil Institution/Pays d'affiliation: Universidade Federal de Minas Gerais/BR