Clinical Risk Factors for Death Caused by Extended-Spectrum Beta-Lactamase: Producing Bacteria

Urol Int. 2019;102(2):205-211. doi: 10.1159/000495314. Epub 2019 Jan 2.

Abstract

Objectives: Extended-spectrum beta-lactamase (ESBL)-producing bacteria often causes bacteremia, leading serious outcomes. In this study, we conducted a retrospective analysis to identify the risk factors associated with death by bacteremia of ESBL-producing bacteria.

Methods: Patients with bacteremia by ESBL-producing bacteria were retrospectively collected in Kobe University Hospital, Japan, between January 2011 and December 2015. Potential risk factors for death caused by ESBL-bacteremia were analyzed for patients' outcome (recovery or death) by univariate and multivariate analysis.

Results: A total of 101 patients (64 male and 37 female) were recruited. The most frequently detected ESBL-producing bacteria were Escherichia coli (91 cases; 90.1%), followed by Klebsiella pneumoniae (8 cases; 7.9%). Most frequently used antibiotics after the detection of bacteremia was meropenem (66.3%; 67/101) followed by cefmetazole (51.5%; 52/101). Univariate analysis showed a significantly positive correlation with mortality in ICU admission (p < 0.001), circulatory diseases (p = 0.022), shock (p = 0.044), and respirator requirement (p = 0.002). Multivariate analysis showed ICU admission remained significant risk factor for mortality (p = 0.0192).

Conclusions: We showed ICU admission was significantly correlated with death from bacteremia by ESBL-producing bacteria. These factors should be monitored to estimate severity of ESBL causing-bacteremia for better patients' outcomes.

Keywords: Infection; Risk factors; Urinary tract infection.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Bacteremia / mortality*
  • Bacteria / enzymology*
  • Bacterial Proteins / metabolism*
  • Cause of Death
  • Child
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units
  • Japan
  • Male
  • Middle Aged
  • Patient Admission
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / microbiology*
  • Urinary Tract Infections / mortality*
  • Young Adult
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • beta-Lactamases