Predominance of healthcare-associated cases among episodes of community-onset bacteraemia due to extended-spectrum β-lactamase-producing Enterobacteriaceae
| Autor: | Jean-Ralph Zahar, Philippe Lesprit, Stephane Ruckly, Aurelia Eden, Hitoto Hikombo, Louis Bernard, Stephan Harbarth, Jean-François Timsit, Christian Brun-Buisson, Nejla Aissa, Alain Losniewski, Sandrine Henard, Christian Rabaud, Cécile Janssen, Léonardo Pagani, Stéphane Bland, Jacques Gaillat, Jean Pierre Bru, Pierre Bonnin, Gaelle Clavère, Virginie Vitrat, Laurence Maulin, Luc Quarsaet, Helene Roger, Jean-Baptiste Euzen, Eric Denes, Elodie Couve-Daecon, Catherine Lechiche, Jean-Philippe Lavigne, Véronique Mondain, Celine Pulcini, Veronique Garnier, Dorothée Lambert, Maxime Hentzien, Yohan Nguyen, Jean Paul Talarmin, Pascaline Rameau, Françoise Geffroy, Arnaud Salmon-Rousseau, Vincent Cattoir, Antoine Froissart, Said Aberrane, Laurence Legout, France Roblot, Guillaume Beraud, Patricia Pavese, Olivier Belmonte, Nicolas Traversier, Laurent Bellec, Marie Lagrange-Xelot, Marie-Pierre Moiton, Barbara Kuli, Pascal Longuet, Agnes Scanvic, Lea Colombain, Milagros Ferreyra, Maxime Jean, Etienne Laurens, Matthieu Saada, Hugues Aumaitre, Martine Malet, Frederique Roustant, Vincent LeMoing, Jean-Pierre Helene, Jonathan Theodore, Caroline Garandeau, Jocelyne Caillon, Benjamin Olivero, David Boutoille, Didier Lepelletier, Lucia Grandière-Perez, Aurélie Beaudron, Céline Ramanantsoa, Catherine Varache, Nicolas Varache, Nicolas Crochette, Hikombo Hitoto, Sophie Blanchi, Pascale Penn, Bernard Louis, Dominique Vanjak, Marie-Christine Escande, René-Gilles Patrigeon, Stéphanie Honoré, Audrey Barrelet, Marlène Amara, Jean-Marc Galempoix, Jean-Claude Réveil, Patricia Bucchiotty, Carine Couzigou, Alban LeMonnier, Emilie Boidin, Stephane Sire, Nelly Luizy, Caroline Bronstain, Carolina Fankhauser, Caroline Brossier, Elodie von Dach, Colette Sauve, Marie-Noelle Adam, Laurent Hocqueloux, Laurent Bret, Marie-Hélène André, Régine Barruet, Marion Challier, Andre Cabié, Benoit Roze, Patrick Plesiat, Katy Jeanot, Isabelle Patry, Joséphine Moreau, Catherine Chirouze, Aaron Laurent, Marie-Nadège Bachelier, Guillaume Kac, Nicolas Farthouat, Nicolas Feuillebois, Thomas Guimard, Sandra Bourdon, Sophie Nguyen, Serge Alfandari, Houcine Bentayeb, Mari-Thérèse Albertini, Bruno Marchou, Noémie Gaudré, Damien Dubois, Christelle Guillet-Caruba, Florence Doucet Populaire, Nicolas Fortineau, Leila Escaut, Vincent Fihman, Rémy Gauzit, Josette Raymond, Solene Kerneis, Veronique Leflon-Guibout, Agnes Lefort, Aurelien Dinh, Anne-Laure Roux, Sophie Abgrall, Françoise Jauréguy, Jean-Christophe Lucet, Nathalie Soismier, Amanda Lopes, Emmanuelle Cambau, Veronique Manceron, Guilène Barnaud |
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| Přispěvatelé: | Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC), Hôpital Foch [Suresnes], Outcomerea, Centre Hospitalier Saint Jean de Perpignan, Centre Hospitalier Le Mans (CH Le Mans), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Faculté de médecine [Genève], Prévention et contrôle des infections (PCI ), Hôpitaux Universitaires de Genève (HUG), Services de Maladies Infectieuses et Tropicales [CHU Bichat], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de réanimation médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours) |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine Pediatrics Bacteremia Community-Acquired Infections/epidemiology/microbiology Antibiotic appropriateness Klebsiella spp 0302 clinical medicine Healthcare associated Risk Factors [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Prevalence Risk of mortality Medicine Pharmacology (medical) Prospective Studies 030212 general & internal medicine beta-Lactamases/secretion Community onset ddc:616 Aged 80 and over Cross Infection education.field_of_study biology Enterobacteriaceae Infections General Medicine Middle Aged Enterobacteriaceae 3. Good health Community-Acquired Infections Treatment Outcome Infectious Diseases [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology Cross Infection/microbiology Female Bacteremia/epidemiology/microbiology Microbiology (medical) medicine.medical_specialty 030106 microbiology Population beta-Lactamases 03 medical and health sciences Extended-spectrum β-lactamase Antibiotic therapy Enterobacteriaceae/classification/enzymology/isolation & purification Humans Risk factor education Aged Enterobacteriaceae Infections/epidemiology/microbiology business.industry biochemical phenomena metabolism and nutrition biology.organism_classification bacterial infections and mycoses Survival Analysis Risk factors [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology Bacteraemia business |
| Zdroj: | International Journal of Antimicrobial Agents International Journal of Antimicrobial Agents, Elsevier, 2017, 49 (1), pp.67-73. ⟨10.1016/j.ijantimicag.2016.09.032⟩ International Journal of Antimicrobial Agents, Vol. 49, No 1 (2017) pp. 67-73 |
| ISSN: | 0924-8579 |
| Popis: | International audience; Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) are endemic pathogens worldwide. Infection with ESBL-PE may be associated with inadequate antibiotic therapy and a poor outcome. However, risk factors for ESBL-PE community-acquired infections are ill-defined. An observational multicentre study was performed in 50 hospitals to identify the prevalence of and risk factors for community-acquired ESBL-PE bacteraemia. All patients presenting with community-onset Enterobacteriaceae bacteraemia were recorded over a 2-month period (between June and November 2013). Risk factors and 14-day outcomes of patients were investigated. Among 682 Enterobacteriaceae bacteraemia episodes recorded, 58 (8.5%) were caused by ESBL-PE. The most frequent species isolated were Escherichia coli (537; 76.7%) and Klebsiella spp. (68; 9.7%), of which 49 (9.1%) and 8 (11.8%), respectively, were ESBL-producers. Most ESBL-PE episodes were healthcare-associated, and only 22 (38%) were apparently community-acquired. The main risk factor for community-acquired ESBL-PE bacteraemia was a prior hospital stay of ≥5 days within the past year. The overall 14-day survival was 90%; only 4 (6.9%) of 58 patients with ESBL-PE bacteraemia died. Inadequate initial antibiotic therapy was administered to 55% of patients with ESBL-PE bacteraemia but was not associated with increased 14-day mortality. Although many patients had community-onset ESBL-PE bacteraemia, almost two-thirds of the episodes were actually healthcare-associated, and true community-acquired ESBL-PE bacteraemia remains rare. In our essentially non-severely ill population, inappropriate initial therapy was not associated with a higher risk of mortality. |
| Databáze: | OpenAIRE |
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