Carbapenems Versus Piperacillin-Tazobactam for Bloodstream Infections of Nonurinary Source Caused by Extended-Spectrum Beta-Lactamase–Producing Enterobacteriaceae

2015 ◽  
Vol 36 (8) ◽  
pp. 981-985 ◽  
Author(s):  
Hadas Ofer-Friedman ◽  
Coral Shefler ◽  
Sarit Sharma ◽  
Amit Tirosh ◽  
Ruthy Tal-Jasper ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multivariate Analysis ◽  
Urinary Tract ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Bloodstream Infections ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Efficacy Analysis ◽  
Extended Spectrum

A recent, frequently quoted study has suggested that for bloodstream infections (BSIs) due to extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL) Escherichia coli, treatment with β-lactam/β-lactamase inhibitors (BLBLIs) might be equivalent to treatment with carbapenems. However, the majority of BSIs originate from the urinary tract. A multicenter, multinational efficacy analysis was conducted from 2010 to 2012 to compare outcomes of patients with non-urinary ESBL BSIs who received a carbapenem (69 patients) vs those treated with piperacillin-tazobactam (10 patients). In multivariate analysis, therapy with piperacillin-tazobactam was associated with increased 90-day mortality (adjusted odds ratio, 7.9, P=.03). For ESBL BSIs of a non-urinary origin, carbapenems should be considered a superior treatment to BLBLIs.Infect Control Hosp Epidemiol 2015;36(8):981–985

scholarly journals Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Patients with Liver Cirrhosis

Pathogens ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
Wen-Chi Chen ◽  
Chih-Hsin Hung ◽  
Yao-Shen Chen ◽  
Jin-Shiung Cheng ◽  
Susan Shin-Jung Lee ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Bloodstream Infections ◽  
Sequence Type ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Admission Rates ◽  
Extended Spectrum ◽  
Cirrhotic Patients

Background: This study aimed to investigate the frequency of sequence type (ST) 131 strains and outcome of cirrhotic patients with bloodstream infections (BSIs) caused by extended-spectrum beta-lactamase-producing Escherichiacoli (ESBLEC) and non-extended-spectrum beta-lactamase-producing Escherichiacoli (NESBLEC). Methods: The incidence of ST 131 strains, hospital stay, and 30-day re-admission/mortality were compared between 51 ESBLEC and 51 NESBLEC bacteremic patients with cirrhosis. Results: ST 131 strains were found in 35.3% of the ESBLEC group and 0% of the NESBLEC group (p < 0.001). Mean hospital stay was 26.5 days in the ESBLEC group and 17.1 days in the NESBLEC group (p = 0.006). Thirty-day re-admission rates were 11.8% in the ESBLEC group and 5.9% in the NESBLEC group (p = 0.5). ST 131 strains were associated with 30-day re-admission (odds ratio: 4.5, 95% confidence interval: 1.1–18.9). Thirty-day mortality rate was 31.4% in the ESBLEC group and 23.5% in the NESBLEC group (p = 0.4). Conclusion: In patients with cirrhosis, the ESBLEC BSIs group had a higher frequency of ST 131 strains and longer hospital stay than the NESBLEC BSIs group with similar 30-day re-admission/mortality. ST 131 strains were associated with 30-day re-admission.

scholarly journals Antimicrobial Susceptibility Pattern and Detection of Extended-Spectrum Beta-Lactamase (blaCTX-M) Gene in Escherichia coli from Urinary Tract Infections at the University Teaching Hospital in Lusaka, Zambia

2020 ◽  
Author(s):  
Emmanuel Chirwa ◽  
Georgina Mulundu ◽  
Kunda Ndashe ◽  
Kalo Kanongesha ◽  
Kaziwe Simpokolwe ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Antimicrobial Susceptibility ◽  
University Teaching ◽  
Beta Lactamase ◽  
M Gene ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Tract Infections ◽  
The University

Urinary tract infections caused by Extended Spectrum Beta-Lactamase producing Escherichia coli are increasing globally and yet treatment still remains a challenge due to antibiotic resistance of the causative agent. The aim of the study was to determine the antimicrobial susceptibility pattern and detect the presence of blaCTX-M gene in Escherichia coli isolated from urinary tract infection patients at the University Teaching Hospital, Lusaka, Zambia. This was a cross-sectional study that involved the collection of urine samples from patients who were diagnosed with urinary tract infections. The samples were cultured on MacConkey agar complemented with cefotaxime and Polymerase Chain Reaction was performed to confirm the Extended-Spectrum Beta-Lactamase producers by detecting the CTX-M gene. Antimicrobial susceptibility tests were conducted using standard methods. A total of 327 urine samples were cultured and 15 (4.6%) of these samples were positive ESBL producers. The isolates showed complete resistance to ampicillin and cotrimoxazole. Multi drug-resistant Extended Spectrum Beta-Lactamase producing Escherichia coli was detected in 4.6 % of UTI patients at the University Teaching Hospital.

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