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.
Artigo
em Inglês
| WPRIM
| ID: wpr-108337
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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Beta-Lactamases
/
Estudos Prospectivos
/
Estudos de Coortes
/
Resultado do Tratamento
/
Bacteriemia
/
Enterobacter
/
Infecções por Enterobacteriaceae
/
Antibacterianos
/
Neoplasias
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Criança
/
Feminino
/
Humanos
/
Lactente
/
Masculino
Idioma:
Inglês
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2014
Tipo de documento:
Artigo
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