Assuntos
Endocardite Bacteriana/diagnóstico , Infecções por Haemophilus/diagnóstico , Haemophilus parainfluenzae/isolamento & purificação , Insuficiência da Valva Mitral/microbiologia , Adulto , Bacteriemia/complicações , Bacteriemia/microbiologia , Diagnóstico Tardio , Ecocardiografia Transesofagiana , Endocardite Bacteriana/diagnóstico por imagem , Endocardite Bacteriana/microbiologia , Feminino , Febre/etiologia , Infecções por Haemophilus/sangue , Infecções por Haemophilus/diagnóstico por imagem , Infecções por Haemophilus/microbiologia , Humanos , Insuficiência da Valva Mitral/diagnóstico por imagem , Doença Relacionada a ViagensRESUMO
BACKGROUND AND OBJECTIVES: Infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) have become a major public health issue worldwide. Cefoxitin is a second-generation cephalosporin and is associated with a strong in vitro activity against ESBL. PATIENTS AND METHODS: We conducted a prospective monocentric cohort study from 2012 to 2015 to evaluate the clinical efficacy and safety of cefoxitin in 15 patients treated for urinary tract infection (UTI) caused by ESBL-E, without any severity criteria. RESULTS: We included 15 patients; 11 were male patients with defined risk factors for ESBL-E. Ten patients presented with male UTI, three with pyelonephritis, and two with cystitis. Escherichia coli was the predominant pathogen. All patients had a positive outcome with a good tolerance (a skin rash without any sign of severity was observed in one patient). Microbiological cure was obtained in 9 patients out of 10 at the end of treatment. CONCLUSION: Cefoxitin is an alternative treatment to carbapenems for urinary tract infections caused by ESBL-producing Enterobacteriaceae.