Klebsiella ESBL bacteremia-mortality and risk factors

Brazilian Journal of Infectious Diseases

Penteado-Filho, Sergio R¹  Terreri, Marcos¹  Tuon, Felipe Francisco¹  Gortz, Lucas¹  Kruger, Margot¹ 

[1] Hospital Universitário Evangélico de Curitiba, Curitiba, Brazil

关键词: Klebsiella pneumoniae;    beta-lactamases;    bacteremia;    carbapenems;   

DOI  :  10.1590/S1413-86702011000600016

来源: Contexto

【 摘 要 】

Background: Extended spectrum β-lactamase (ESBL)-producing bacteria have become recognized as a problem in South America. The aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by ESBL-producing Klebsiella pneumoniae in a Brazilian hospital. Methods: A three-year retrospective cohort study with 104 cases of K. pneumoniae bacteremia (61 ESBL and 43 non-ESBL). Several clinical and laboratory variables were evaluated. The outcome of interest was 30-day mortality. The adequate treatment was evaluated according to antibiotic susceptibility. Results: Multivariable analysis showed that central venous catheter and mechanical ventilation were independent risk factors for ESBL. The duration of hospitalization before the bacteremia was not a risk factor. Mortality was similar in ESBL and non-ESBL and inadequate therapy was not shown to be a risk factor. Conclusion: ESBL-producing Klebsiella bacteremia can occur early, suggesting that a carbapenem should be included in the initial empirical therapy for bacteremia in patients under mechanical ventilation and/or central venous catheter in our institution.

【 授权许可】

CC BY-NC-ND