دورية أكاديمية
أعرض في EDS

Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study.

التفاصيل البيبلوغرافية
العنوان: Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study.
المؤلفون: Peralta G; Instituto de Formación e Investigación Marqués de Valdecilla, 3ª Planta, Edificio IFIMAV, Avda Cardenal Herrera Oria, 39011 Santander, Spain. gpf@mundivia.es, Lamelo M, Alvarez-García P, Velasco M, Delgado A, Horcajada JP, Montero M, Roiz MP, Fariñas MC, Alonso J, Martínez LM, Gutiérrez-Macías A, Alava JA, Rodríguez A, Fleites A, Navarro V, Sirvent E, Capdevila JA
مؤلفون مشاركون: SEMI- BLEE STUDY GROUP
المصدر: BMC infectious diseases [BMC Infect Dis] 2012 Oct 05; Vol. 12, pp. 245. Date of Electronic Publication: 2012 Oct 05.
نوع المنشور: Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Anti-Bacterial Agents/*therapeutic use , Bacteremia/*drug therapy , Escherichia coli/*enzymology , Escherichia coli Infections/*drug therapy , Klebsiella/*enzymology , Klebsiella Infections/*drug therapy , beta-Lactamases/*metabolism, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bacteremia/microbiology ; Bacteremia/mortality ; Child ; Child, Preschool ; Cohort Studies ; Escherichia coli/isolation & purification ; Escherichia coli Infections/microbiology ; Escherichia coli Infections/mortality ; Female ; Humans ; Infant ; Infant, Newborn ; Klebsiella/isolation & purification ; Klebsiella Infections/microbiology ; Klebsiella Infections/mortality ; Male ; Middle Aged ; Spain ; Survival Analysis ; Treatment Outcome ; Young Adult
مستخلص: Background: The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia.
Methods: Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression.
Results: We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients.
Conclusion: ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited.
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فهرسة مساهمة: Investigator: C Amador; FJ Arjona; E Chamarro Martí; Mdel M Pérez Moreno; M Belhassen García; A Herrero-Hernández; M Delgado Vicente; A Canut; J Sola; JJ García Irure; A Almazán Gavidia; A Castro Salomó; M Fernández Ayala; P Mellado; M Sanz Franco; C Martín Salas; J Ramón Bermúdez; I Rodríguez-Conde; M Javayolas
المشرفين على المادة: 0 (Anti-Bacterial Agents)
EC 3.5.2.6 (beta-Lactamases)
تواريخ الأحداث: Date Created: 20121009 Date Completed: 20130429 Latest Revision: 20220330
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC3519701
DOI: 10.1186/1471-2334-12-245
PMID: 23038999
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2334
DOI:10.1186/1471-2334-12-245