TITLE

Risks Factors for Infections with Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae at a Tertiary Care University Hospital in Switzerland

AUTHOR(S)
Kuster, S. P.; Hasse, B.; Huebner, V.; Bansal, V.; Zbinden, R.; Ruef, C.; Ledergerber, B.; Weber, R.
PUB. DATE
February 2010
SOURCE
Infection;Feb2010, Vol. 38 Issue 1, p33
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
There are considerable geographical differencesin the occurrence of extended-spectrum beta-lactamase(ESBL)-producing bacteria, both in the community and in thehospital setting. Our aim was to assess risk factors forbloodstream, urinary tract, and vascular catheter-associatedinfections with ESBL-producing Escherichia coli and Klebsiellapneumoniae at a tertiary care hospital in a low-prevalencecountry. We performed a case-control study comparing 58patients with infections due to ESBL-producing E. coli or K. pneumoniae vs 116 controls with infections due to non-ESBL producing organisms at the University Hospital Zurich,Switzerland, between 1 July 2005 and 30 June 2007. Cases included 15 outpatients and 43 inpatients.Multivariable analyses found three risk factors for ESBL-producingisolates: begin of symptoms or recent antibioticpre-treatment in a foreign country (odds ratio [OR] 27.01,95% confidence interval [CI] 2.38–1,733.28], p = 0.042),antibiotic therapy within the year preceding the isolation ofthe ESBL-producing strain (OR 2.88, 95% CI 1.13–8.49,p = 0.025), and mechanical ventilation (OR 10.56, 95% CI1.06–579.10, p = 0.042). The major risk factors for infections due toESBL-producing bacteria were travel in high-prevalencecountries, prior antibiotic use, and mechanical ventilationduring a stay in the intensive care unit. Community-acquiredinfections were documented in 17% of the patients.An early identification of risk factors is crucial to providingthe patients an optimal empiric antibiotic therapy and tokeep the use of carbapenems to a minimum.
ACCESSION #
48191045

 

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