Comparison of  the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum \u3b2-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP

Akova, M

Almirante, B

Bermejo, J

Bonomo, Ra

Bou, G

Calbo, E

Carmeli, Y

de la Calle, C

Gasch, O

Gozalo, M

Guti\ue9rrez-Guti\ue9rrez, B

Hamprecht, A

Hern\ue1ndez-Torres, A

Hsueh, Pr

Karaiskos, I

Lowman, W

Molina, J

Navarro-San Francisco, C

Oliver, A

Orig\ufcen, J

P\ue9rez, F

Pascual, A

Paterson, Dl

Pe\uf1a, C

Pitout, J

Prim, N

Rodr\uedguez-Ba\uf1o, J

Ruiz-Garbajosa, P

Schechner, V

Scheuerman, O

Schwaber, Mj

Tacconelli, E

Tumbarello, M

Venditti, M

Viale, Pl

OBJECTIVETo compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypesMETHODSAs part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.RESULTSThe study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non-CTX-M ESBLs were detected.CONCLUSIONSClinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detecte

Scheuerman O

Schechner V

Carmeli Y

Gutiérrez-Gutiérrez B

Calbo E

Almirante B

Viale P

Oliver A

Ruiz-Garbajosa P

Gasch O

Gozalo M

Pitout J

Akova M

Peña C

Molina J

Hernández-Torres A

Venditti M

Prim N

Origüen J

Bou G

Tacconelli E

Tumbarello M

Hamprecht A

Karaiskos I

de la Calle C

Pérez F

Schwaber MJ

Bermejo J

Lowman W

Hsueh PR

Navarro-San Francisco C

Bonomo RA

Paterson DL

Pascual A

Rodríguez-Baño J

Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae

Comparison of  the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP

Viale PL

SOLER MOLINA, Joan Abel

GOMEZ PEREZ, Fernando Luis

TOLA PASCUAL, ALBERT

Catalogo dei prodotti della ricerca

Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae.

https://iris.univr.it/bitstream/11562/981998/1/comparison_of_predictors_and_mortality_between_bloodstream_infections_caused_by_esblproducing_escherichia_coli_and_esblproducing_klebsiella_pneumoniae.pdf

Comparison of Predictors and Mortality Between Bloodstream Infections Caused by ESBL-Producing Escherichia coli and ESBL-Producing Klebsiella pneumoniae.

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Archivio istituzionale della ricerca - Alma Mater Studiorum Università di Bologna

Catalogo dei prodotti della ricerca