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Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis.
Chemotherapy. 2012; 58(3):217-24.C

Abstract

AIM

To describe the risk factors and molecular epidemiology of nosocomial bloodstream infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in a tertiary care hospital.

METHODS

Patients with enterobacteria-positive blood cultures were included. ESBL expression in the isolates was detected using the combination disk method. Antimicrobial susceptibility testing was performed using the disk diffusion method. bla(SHV), bla(TEM), and bla(CTX-M) genes were identified in the isolated strains by PCR and sequencing. Klebsiella pneumoniae isolates were genotyped by PFGE.

RESULTS

Of the 90 isolates recovered, half were found to express ESBLs. Twenty-eight (62%) of these isolates were K. pneumoniae, 8 (18%) were Escherichia coli, 6 (13%) were Enterobacter cloacae, and 3 (7%) were Serratia marcescens. Multivariate logistic regression analysis showed that the only independent risk factor associated with infection by ESBL-producing strains was use of broad-spectrum cephalosporins. None of the isolates was resistant to imipenem. The bla(SHV5) gene was detected in 84% of isolates, followed by bla(CTX-M15) (27%), bla(SHV2) (9%), and bla(SHV12) (7%). PFGE identified six clones among the 28 ESBL-producing K. pneumoniae isolates.

CONCLUSIONS

ESBL-producing K. pneumoniae clones were detected throughout the hospital. Use of broad-spectrum cephalosporins is the most important risk factor associated with the proliferation of ESBL-producing strains.

Authors+Show Affiliations

Servicio de Infectología, Hospital Universitario Dr. José Eleuterio González, Monterrey, Mexico.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22814216

Citation

Muro, Sissy, et al. "Risk Factors Associated With Extended-spectrum Β-lactamase-producing Enterobacteriaceae Nosocomial Bloodstream Infections in a Tertiary Care Hospital: a Clinical and Molecular Analysis." Chemotherapy, vol. 58, no. 3, 2012, pp. 217-24.
Muro S, Garza-González E, Camacho-Ortiz A, et al. Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis. Chemotherapy. 2012;58(3):217-24.
Muro, S., Garza-González, E., Camacho-Ortiz, A., González, G. M., Llaca-Díaz, J. M., Bosques, F., & Rositas, F. (2012). Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis. Chemotherapy, 58(3), 217-24. https://doi.org/10.1159/000339483
Muro S, et al. Risk Factors Associated With Extended-spectrum Β-lactamase-producing Enterobacteriaceae Nosocomial Bloodstream Infections in a Tertiary Care Hospital: a Clinical and Molecular Analysis. Chemotherapy. 2012;58(3):217-24. PubMed PMID: 22814216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors associated with extended-spectrum β-lactamase-producing Enterobacteriaceae nosocomial bloodstream infections in a tertiary care hospital: a clinical and molecular analysis. AU - Muro,Sissy, AU - Garza-González,Elvira, AU - Camacho-Ortiz,Adrian, AU - González,Gloria María, AU - Llaca-Díaz,Jorge Martín, AU - Bosques,Francisco, AU - Rositas,Félix, Y1 - 2012/07/19/ PY - 2011/10/04/received PY - 2012/05/14/accepted PY - 2012/7/21/entrez PY - 2012/7/21/pubmed PY - 2013/1/8/medline SP - 217 EP - 24 JF - Chemotherapy JO - Chemotherapy VL - 58 IS - 3 N2 - AIM: To describe the risk factors and molecular epidemiology of nosocomial bloodstream infections caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in a tertiary care hospital. METHODS: Patients with enterobacteria-positive blood cultures were included. ESBL expression in the isolates was detected using the combination disk method. Antimicrobial susceptibility testing was performed using the disk diffusion method. bla(SHV), bla(TEM), and bla(CTX-M) genes were identified in the isolated strains by PCR and sequencing. Klebsiella pneumoniae isolates were genotyped by PFGE. RESULTS: Of the 90 isolates recovered, half were found to express ESBLs. Twenty-eight (62%) of these isolates were K. pneumoniae, 8 (18%) were Escherichia coli, 6 (13%) were Enterobacter cloacae, and 3 (7%) were Serratia marcescens. Multivariate logistic regression analysis showed that the only independent risk factor associated with infection by ESBL-producing strains was use of broad-spectrum cephalosporins. None of the isolates was resistant to imipenem. The bla(SHV5) gene was detected in 84% of isolates, followed by bla(CTX-M15) (27%), bla(SHV2) (9%), and bla(SHV12) (7%). PFGE identified six clones among the 28 ESBL-producing K. pneumoniae isolates. CONCLUSIONS: ESBL-producing K. pneumoniae clones were detected throughout the hospital. Use of broad-spectrum cephalosporins is the most important risk factor associated with the proliferation of ESBL-producing strains. SN - 1421-9794 UR - https://www.unboundmedicine.com/medline/citation/22814216/Risk_factors_associated_with_extended_spectrum_β_lactamase_producing_Enterobacteriaceae_nosocomial_bloodstream_infections_in_a_tertiary_care_hospital:_a_clinical_and_molecular_analysis_ L2 - https://www.karger.com?DOI=10.1159/000339483 DB - PRIME DP - Unbound Medicine ER -