Scheuerman, Oded, Schechner, Vered, Carmeli, Yehuda, Gutierrez-Gutierrez, Belen, Calbo, Esther, Almirante, Benito ORCID: 0000-0002-1189-2361, Viale, Pier-Luigy, Oliver, Antonio ORCID: 0000-0001-9327-1894, Ruiz-Garbajosa, Patricia, Gasch, Oriol, Gozalo, Monica, Pitout, Johann, Akova, Murat, Pena, Carmen, Molina, Jose, Hernandez-Torres, Alicia, Venditti, Mario, Prim, Nuria, Origuen, Julia, Bou, German ORCID: 0000-0001-8837-0062, Tacconelli, Evelina, Tumbarello, Maria, Hamprecht, Axel ORCID: 0000-0003-1449-5780, Karaiskos, Ilias ORCID: 0000-0002-2226-0239, de la Calle, Cristina, Perez, Federico, Schwaber, Mitchell J., Bermejo, Joaquin, Lowman, Warren ORCID: 0000-0002-6981-389X, Hsueh, Po-Ren, Navarro-San Francisco, Carolina, Bonomo, Robert A., Paterson, David L., Pascual, Alvaro ORCID: 0000-0002-8672-5891 and Rodriguez-Bano, Jesus ORCID: 0000-0001-6732-9001 (2018). Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae. Infect. Control Hosp. Epidemiol., 39 (6). S. 660 - 668. NEW YORK: CAMBRIDGE UNIV PRESS. ISSN 1559-6834

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Abstract

OBJECTIVETo compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum -lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypesMETHODSAs part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.RESULTSThe study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non-CTX-M ESBLs were detected.CONCLUSIONSClinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.CLINICAL TRIALS IDENTIFIERClinicalTrials.gov. Identifier: NCT01764490.Infect Control Hosp Epidemiol 2018;39:660-667

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Scheuerman, OdedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schechner, VeredUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carmeli, YehudaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gutierrez-Gutierrez, BelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Calbo, EstherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Almirante, BenitoUNSPECIFIEDorcid.org/0000-0002-1189-2361UNSPECIFIED
Viale, Pier-LuigyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oliver, AntonioUNSPECIFIEDorcid.org/0000-0001-9327-1894UNSPECIFIED
Ruiz-Garbajosa, PatriciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gasch, OriolUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gozalo, MonicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pitout, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akova, MuratUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pena, CarmenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Molina, JoseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hernandez-Torres, AliciaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Venditti, MarioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Prim, NuriaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Origuen, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bou, GermanUNSPECIFIEDorcid.org/0000-0001-8837-0062UNSPECIFIED
Tacconelli, EvelinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tumbarello, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamprecht, AxelUNSPECIFIEDorcid.org/0000-0003-1449-5780UNSPECIFIED
Karaiskos, IliasUNSPECIFIEDorcid.org/0000-0002-2226-0239UNSPECIFIED
de la Calle, CristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Perez, FedericoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwaber, Mitchell J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bermejo, JoaquinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lowman, WarrenUNSPECIFIEDorcid.org/0000-0002-6981-389XUNSPECIFIED
Hsueh, Po-RenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Navarro-San Francisco, CarolinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bonomo, Robert A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Paterson, David L.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pascual, AlvaroUNSPECIFIEDorcid.org/0000-0002-8672-5891UNSPECIFIED
Rodriguez-Bano, JesusUNSPECIFIEDorcid.org/0000-0001-6732-9001UNSPECIFIED
URN: urn:nbn:de:hbz:38-183376
DOI: 10.1017/ice.2018.63
Journal or Publication Title: Infect. Control Hosp. Epidemiol.
Volume: 39
Number: 6
Page Range: S. 660 - 668
Date: 2018
Publisher: CAMBRIDGE UNIV PRESS
Place of Publication: NEW YORK
ISSN: 1559-6834
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LACTAMASE; ENTEROBACTERIACEAE; BACTEREMIA; THERAPYMultiple languages
Public, Environmental & Occupational Health; Infectious DiseasesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/18337

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