The impact of production of extended-spectrum β-lactamases on the 28-day mortality rate of patients with Proteus mirabilis bacteremia in Korea

BMC Infectious Diseases

Research Article

Je Eun Song¹  Jin Young Ahn²  Wooyoung Jeong³  Moo Hyun Kim³  Su Jin Jeong⁴  In Young Jung⁴  Mi Young Ahn⁴  Young Goo Song⁴  Yongduk Jeon⁴  Jun Yong Choi⁴  Eun Jin Kim⁴  June Myung Kim⁴  Hea Won Ann⁴  Dong Hyun Oh⁴  Yong Chan Kim⁴  Nam Su Ku⁵  Dongeun Yong⁶ 

[1] Department of Internal Medicine, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, South Korea;Department of Internal Medicine, Seoul Medical Center, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea;Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea;Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 120-752, Seoul, South Korea;Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, South Korea;

关键词: Proteus Mirabilis;    Bacteremia;    Extended-spectrum β-lactamase;    Mortality;   

DOI  :  10.1186/s12879-017-2431-8

 received in 2017-01-01, accepted in 2017-04-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe incidence of Proteus mirabilis antimicrobial resistance, especially that mediated by extended-spectrum β-lactamases (ESBLs), has increased. We investigated the impact of ESBL production on the mortality of patients with P. mirabilis bacteremia in Korea.MethodsPatients diagnosed with P. mirabilis bacteremia between November 2005 and December 2013 at a 2000-bed tertiary care center in South Korea were included in this study. Phenotypic and molecular analyses were performed to assess ESBL expression. Characteristics and treatment outcomes were investigated among ESBL-producing and non-ESBL-producing P. mirabilis bacteremia groups. A multivariate analysis of 28-day mortality rates was performed to evaluate the independent impact of ESBLs.ResultsAmong 62 P. mirabilis isolates from 62 patients, 14 expressed ESBLs (CTX-M, 2; TEM, 5; both, 6; other, 1), and the 28-day mortality rate of the 62 patients was 17.74%. No clinical factor was significantly associated with ESBL production. The 28-day mortality rate in the ESBL-producing group was significantly higher than that in the non-ESBL-producing group (50% vs. 8.3%, p = 0.001). A multivariate analysis showed that ESBL production (odds ratio [OR], 11.53, 95% confidence interval [CI], 2.11–63.05, p = 0.005) was independently associated with the 28-day mortality rate in patients with P. mirabilis bacteremia.ConclusionsESBL production is significantly associated with mortality in patients with bacteremia caused by P. mirabilis. Rapid detection of ESBL expression and prompt appropriate antimicrobial therapy are required to reduce mortality caused by P. mirabilis bacteremia.

【 授权许可】

CC BY   
© The Author(s). 2017