scholarly journals Risk Factors for Gastrointestinal Tract Colonization with Extended-Spectrum β-Lactamase (ESBL)–Producing Escherichia coli and Klebsiella Species in Hospitalized Patients

2012 ◽  
Vol 33 (12) ◽  
pp. 1242-1245 ◽  
Author(s):  
Jennifer H. Han ◽  
Irving Nachamkin ◽  
Theoklis E. Zaoutis ◽  
Susan E. Coffin ◽  
Darren R. Linkin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gastrointestinal Tract ◽  
Hospital Stay ◽  
Hospitalized Patients ◽  
Prior Exposure ◽  
Klebsiella Species ◽  
Duration Of Hospital Stay ◽  
Extended Spectrum

We describe the prevalence of and risk factors for colonization with extended-spectrum β-lactamase (ESBL)–producing Escherichia coli and Klebsiella species (ESBL-EK) in hospitalized patients. The prevalence of colonization with ESBL-EK was 2.6%. Colonization was associated with cirrhosis, longer duration of hospital stay prior to surveillance, and prior exposure to clindamycin or meropenem.

scholarly journals Risk Factors for Increasing Multidrug Resistance among Extended-Spectrum  -Lactamase-Producing Escherichia coli and Klebsiella Species

2005 ◽  
Vol 40 (9) ◽  
pp. 1317-1324 ◽  
Author(s):  
E. P. Hyle ◽  
A. D. Lipworth ◽  
T. E. Zaoutis ◽  
I. Nachamkin ◽  
N. O. Fishman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Multidrug Resistance ◽  
Klebsiella Species ◽  
Extended Spectrum

Risk Factors for and Outcomes of Bloodstream Infection Caused by Extended-Spectrum ss-Lactamase-Producing Escherichia coli and Klebsiella Species in Children

PEDIATRICS ◽  
2005 ◽  
Vol 115 (4) ◽  
pp. 942-949 ◽  
Author(s):  
T. E. Zaoutis ◽  
M. Goyal ◽  
J. H. Chu ◽  
S. E. Coffin ◽  
L. M. Bell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Bloodstream Infection ◽  
Klebsiella Species ◽  
Extended Spectrum

scholarly journals 1438. Prevalence and Risk Factors for Extended Spectrum Betalactamases Among Hospitalized Patients with Community Acquired Pyelonephritis in Colombia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Mariana Franco Rodríguez ◽  
Jorge Cortes
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Logistic Regression ◽  
Hospitalized Patients ◽  
Adult Patients ◽  
Charlson Score ◽  
Esbl Production ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections

Abstract Background Urinary tract infections (UTI) are the most frequent bacterial infection in hospitalized patients. Extented spectrum betalactamases (ESBL) producing bacteria causing UTI have become more prevalent. Escherichia coli (E. coli) is the most frequent ESBL producing bacteria isolated in UTI. This drug resistant organisms are associated with poorer outcomes for patients. In low income countries, approaching to and treating ESBL E. coli, represent a major challenge for health care centers. Methods A retrospective cohort of adult patients with community acquired pyelonephritis caused by Escherichia coli was identified in a tertiary hospital in Colombia. Susceptibility was performed with Vitek (BioMerieux, France); extended spectrum beta lactamase (ESBL) production was defined phenotypically. Inclusion criteria were adult patients hospitalized with a positive urine culture for E. coli. Demographic and clinical characteristics were searched in electronic records. Risk factors associated with ESBL production were identified by using a multivariate logistic regression analysis. Results During 7 years 817 patients with pyelonephritis caused by E. coli were identified. 79 (9.7%) of them were caused by ESBL producers. Women were 66% and 408 (74.8% of them) had menopause. Mean age was 64.2 years (standard deviation of 19.1). Of the cohort, 481 (561.1%) had at least some comorbidity and was frequent to find diabetes (18.5%), immunosuppression due to oncologic disease or medications (18.4%), urolithiasis or previous surgical procedures (17%). After logistic regression, risk factors identified to predict ESBL production, were: being a man (aOR 5.4, 2.1-18.2), a woman with menopause (aOR 2.9, 1.3 -9.9), and the Charlson score (aOR 0.83, 0.73 – 0.96). Previous antibiotic use was not related to ESBL infection. Conclusion In this relatively large cohort of patients with pyelonephritis caused by E. coli, ESBL production risk factors were not clearly identified other than sex and menopause. Curiously, Charlson score predicted a lower risk of resistance. Other factors (food consumptions and others) might be driving the resistance in the community in E. coli. Disclosures Jorge Cortes, MD, Pfizer (Research Grant or Support)

scholarly journals Gastrointestinal Tract Colonization With Fluoroquinolone-Resistant Escherichia coli in Hospitalized Patients: Changes Over Time in Risk Factors for Resistance

2009 ◽  
Vol 30 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Ebbing Lautenbach ◽  
Joshua P. Metlay ◽  
Mark G. Weiner ◽  
Warren B. Bilker ◽  
Pam Tolomeo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Gastrointestinal Tract ◽  
Clinical Epidemiology ◽  
Resistance Mechanisms ◽  
Hospitalized Patients ◽  
Bivariable Analysis ◽  
Duration Of Hospitalization ◽  
Changes Over Time ◽  
Over Time

Objective.The prevalence of fluoroquinolone (FQ) resistance in Escherichia coli has increased markedly in recent years. Despite the important role of gastrointestinal tract colonization with FQ-resistant E. coli (FQREC), the prevalence of and risk factors for FQREC colonization among the general hospitalized patient population have not been described, to our knowledge. The objective of this study was to identify the prevalence of and risk factors for FQREC colonization among hospitalized patients.Design.Three-year case-control study. Case patients (ie, all subjects with FQREC colonization) were compared with control patients (ie, all subjects without FQREC colonization).Setting.Two large medical centers within an academic health system.Participants.All patients hospitalized at the 2 study hospitals.Main Outcome Measure.Three annual fecal surveillance surveys were conducted. All patients colonized with FQREC (levofloxacin minimum inhibitory concentration, ≥ 8 μg/mL) were identified.Results.Of the 774 subjects, 89 (11.5%) were colonized with FQREC. Although there was a significant association between prior FQ use and FQREC colonization on bivariable analysis (odds ratio [OR], 2.02 [95% confidence interval {CI}, 1.14–3.46]; P = .01), there was statistically significant effect modification by year of study (P = .005). In multivariable analyses, after controlling for the hospital and for the duration of hospitalization prior to sampling, the association between FQ use and FQREC colonization was as follows: adjusted OR (aOR), 0.97 (95% CI, 0.29–3.23) in 2002; aOR, 1.41 (95% CI, 0.57–3.50) in 2003; and aOR, 9.87 (95% CI, 3.67–26.55) in 2004.Conclusions.The association between prior FQ use and FQREC colonization varied significantly by study year, suggesting that the clinical epidemiology of resistant organisms may change over time. Furthermore, in the context of recent work showing significant changes in FQREC prevalence as well as changes in FQ resistance mechanisms (specifically, efflux overexpression) over the same time period, these results suggest a previously unrecognized complexity in the relationship between the clinical and molecular epidemiology of FQ resistance.

scholarly journals Impact of Extended-Spectrum β-Lactamase Production on Treatment Outcomes of Acute Pyelonephritis Caused by Escherichia coli in Patients without Health Care-Associated Risk Factors

2015 ◽  
Vol 59 (4) ◽  
pp. 1962-1968 ◽  
Author(s):  
Sun Hee Park ◽  
Su-Mi Choi ◽  
Dong-Gun Lee ◽  
Sung-Yeon Cho ◽  
Hyo-Jin Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Health Care ◽  
Treatment Outcomes ◽  
Acute Pyelonephritis ◽  
Esbl Production ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
The Impact

ABSTRACTExtended-spectrum β-lactamase-producingEscherichia coli(ESBL-EC) is increasingly identified as a cause of acute pyelonephritis (APN) among patients without recent health care contact, i.e., community-associated APN. This case-control study compared 75 cases of community-associated ESBL-EC APN (CA-ESBL) to 225 controls of community-associated non-ESBL-EC APN (CA-non-ESBL) to identify the risk factors for ESBL-EC acquisition and investigate the impact of ESBL on the treatment outcomes of community-associated APN (CA-APN) caused byE. coliat a Korean hospital during 2007 to 2013. The baseline characteristics were similar between the cases and controls; the risk factors for ESBL-EC were age (>55 years), antibiotic use within the previous year, and diabetes with recurrent APN. The severity of illness did not differ between CA-ESBL and CA-non-ESBL (Acute Physiology and Chronic Health Evaluation [APACHE] II scores [mean ± standard deviation], 7.7 ± 5.9 versus 6.4 ± 5.3;P= 0.071). The proportions of clinical (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.57 to 5.38;P= 0.323) and microbiological (OR, 1.16; 95% CI, 0.51 to 2.65;P= 0.730) cures were similar, although the CA-ESBL APN patients were less likely to receive appropriate antibiotics within 48 h. A multivariable Cox proportional hazards analysis of the prognostic factors for CA-APN caused byE. colishowed that ESBL production was not a significant factor for clinical (hazard ratio [HR], 0.39; 95% CI, 0.12 to 1.30;P= 0.126) or microbiological (HR, 0.49; 95% CI, 0.21 to 1.12;P= 0.091) failure. The estimates did not change after incorporating weights calculated using propensity scores for acquiring ESBL-EC. Therefore, ESBL production did not negatively affect treatment outcomes among patients with community-associatedE. coliAPN.

Sign in / Sign up

Export Citation Format

Share Document