Klebsiella ESBL bacteremia-mortality and risk factors

Braz J Infect Dis. 2011 Nov-Dec;15(6):594-8. doi: 10.1590/s1413-86702011000600016.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / microbiology
  • Bacteremia / mortality*
  • Child
  • Cohort Studies
  • Cross Infection / microbiology
  • Cross Infection / mortality*
  • Female
  • Humans
  • Klebsiella Infections / microbiology
  • Klebsiella Infections / mortality*
  • Klebsiella pneumoniae / enzymology*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Young Adult
  • beta-Lactamases / metabolism*

Substances

  • beta-Lactamases