Irish journal of medical science · 2013
Risk factors for hospital-acquired bloodstream infections caused by extended-spectrum β-lactamase Klebsiella pneumoniae among cancer patients.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Li D, Chen Y, Zhang W, Zheng S, Zhang Q, Bai C, Zhang P
Аннотация
BACKGROUND: Incidence of infection due to extended-spectrum β-lactamase producing Klebsiella pneumoniae (ESBL-KP) has increased rapidly in recent years. However, its prevalence in cancer patients is seldom reported.
AIMS: This study was designed to identify the risk factors for bloodstream infections (BSIs) with ESBL-KP, and to understand its susceptibility among cancer patients on antibiotics.
METHODS: We conducted a retrospective study with a total of 118 cancer patients between 2009 and 2011 with BSIs, among which 88 were infected with non-ESBL-KP and 30 with ESBL-KP. Patterns of susceptibility, clinical characteristics and mortality were investigated. Multivariate logistic regression model was used to unveil independent risk factors.
RESULTS: On multivariate analysis, length of stay (LOS) (p = 0.025), and prior exposure to cephalosporins (p = 0.006), fluoroquinolones (p = 0.011), macrolides (p = 0.007) and aminoglycosides (p = 0.008) were independent risk factors for BSIs of ESBL-KP. For mortality, there was no significant difference between ESBL-KP and non-ESBL-KP groups (p = 0.431). Moreover, compared with non-ESBL-KP, ESBL-KP displayed reduced sensitivity to aminoglycosides (p < 0.001, except amikacin), fluoroquinolones (p < 0.001), piperacillin-tazobactam (p = 0.005) and trimethoprim-sulfamethoxazole (p < 0.001), respectively.
CONCLUSIONS: ESBL-KP exhibited less susceptibility to various non-β-lactamase antibiotics, and infections due to these organisms were related to LOS and preexisting use of antibiotics. Thus, judicious use of all antibiotics should be underscored to reduce the infections caused by ESBL-KP.
AIMS: This study was designed to identify the risk factors for bloodstream infections (BSIs) with ESBL-KP, and to understand its susceptibility among cancer patients on antibiotics.
METHODS: We conducted a retrospective study with a total of 118 cancer patients between 2009 and 2011 with BSIs, among which 88 were infected with non-ESBL-KP and 30 with ESBL-KP. Patterns of susceptibility, clinical characteristics and mortality were investigated. Multivariate logistic regression model was used to unveil independent risk factors.
RESULTS: On multivariate analysis, length of stay (LOS) (p = 0.025), and prior exposure to cephalosporins (p = 0.006), fluoroquinolones (p = 0.011), macrolides (p = 0.007) and aminoglycosides (p = 0.008) were independent risk factors for BSIs of ESBL-KP. For mortality, there was no significant difference between ESBL-KP and non-ESBL-KP groups (p = 0.431). Moreover, compared with non-ESBL-KP, ESBL-KP displayed reduced sensitivity to aminoglycosides (p < 0.001, except amikacin), fluoroquinolones (p < 0.001), piperacillin-tazobactam (p = 0.005) and trimethoprim-sulfamethoxazole (p < 0.001), respectively.
CONCLUSIONS: ESBL-KP exhibited less susceptibility to various non-β-lactamase antibiotics, and infections due to these organisms were related to LOS and preexisting use of antibiotics. Thus, judicious use of all antibiotics should be underscored to reduce the infections caused by ESBL-KP.
Предметные рубрики MeSH
AdultAgedAnti-Bacterial AgentsBacteremiaCase-Control StudiesCephalosporinsCross InfectionDrug Resistance, BacterialFemaleHospital MortalityHumansIncidenceKlebsiella InfectionsKlebsiella pneumoniaeLength of StayLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasmsPrevalenceRetrospective StudiesRisk Factorsbeta-Lactamases