Enterobacteriaceae bacteremia: risk factors for ESBLPE
| Autor: | Isabelle Lolom, Laurence Armand-Lefevre, Etienne Ruppé, J.-C. Lucet, C. Neulier, Yazdan Yazdanpanah, A. Andremont, Gabriel Birgand |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Paris Adolescent Databases Factual medicine.drug_class Antibiotics Hospital Departments Bacteremia Logistic regression beta-Lactam Resistance beta-Lactamases Teaching hospital Substrate Specificity Young Adult Bacterial Proteins Enterobacteriaceae Risk Factors Internal medicine medicine Prevalence Humans In patient Prospective Studies Child Hospitals Teaching Aged Computerized databases Aged 80 and over biology business.industry Enterobacteriaceae Infections Infant Newborn Infant Middle Aged biology.organism_classification medicine.disease Surgery Infectious Diseases Carriage Carbapenems Child Preschool Carrier State Female business |
| Zdroj: | Medecine et maladies infectieuses. 44(1) |
| ISSN: | 1769-6690 |
| Popis: | Objectives The increasing prevalence of extended spectrum beta-lactamase producing enterobacteriaceae (ESBLPE) requires defining the use of carbapenems in first intention. We analyzed the associations between enterobacteriaceae bacteremia (EbBact) and ESBLPE carriage during 10 years in a 950-bed teaching hospital. Methods We analyzed a 10-year (July 2001 to June 2011) prospective collection of bacteremia cases including 2 databases: (1) EbBact and (2) a computerized database of patients carrying EBLSE. Only one episode of EbBact was analyzed per patient and hospital stay. Factors associated with ESBLPE bacteremia were assessed by univariate and multivariate logistic regression analysis. Results Overall, 2355 cases of EbBact were identified, among which 135 (5.7%) were ESBLPE (2001–05: 1.4%, 2006–09: 7.6%, 2010–11: 14.2%). ESBLPE bacteremia was observed in 52 of the 88 (59%) patients carrying ESBLPE and in 83/2267 (3.7%) patients not known to be colonized with ESBLPE. Factors associated with ESBLPE bacteremia in patients not known to be colonized were: female gender (ORa = 0.56, CI95% [0.34–0.91]), hospitalization in the ICU (ORa = 2.51 [1.27–5.05]) or medical/surgical wards (ORa = 1.83 [1.04–3.38]), the period (2006–09, ORa = 4.08 [2.21–8.16]; 2010–11, ORa = 8.17 [4.14–17.06] compared to 2001–05), and history of EbBact (ORa = 2.29 [0.97–4.79]). Conclusion In case of EbBact, patients known to be colonized with ESBLPE present with ESBLPE bacteremia in more than half of the cases, requiring carbapenems as empirical antibiotic treatment. The global prevalence of ESBLPE among patients presenting with EbBact not known to be colonized with ESBLPE was 3.7%. |
| Databáze: | OpenAIRE |
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