Your browser doesn't support javascript.
loading
Colonisation and infection due to Enterobacteriaceae producing plasmid-mediated AmpC ß-lactamases.
Rodríguez-Baño, Jesús; Miró, Elisenda; Villar, Macarena; Coelho, Alicia; Gozalo, Mónica; Borrell, Nuria; Bou, Germán; Conejo, M Carmen; Pomar, Virginia; Aracil, Belén; Larrosa, Nieves; Agüero, Jesús; Oliver, Antonio; Fernández, Ana; Oteo, Jesús; Pascual, Alvaro; Navarro, Ferran.
Afiliação
  • Rodríguez-Baño J; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Avda Dr Fedriani 3, 41009 Sevilla, Spain. jesusrb@us.es
J Infect ; 64(2): 176-83, 2012 Feb.
Article em En | MEDLINE | ID: mdl-22138600
OBJECTIVES: To investigate the epidemiology and clinical features of infections caused by Enterobacteria producing plasmid-mediated AmpC ß-lactamases (pAmpC), which are emerging as a cause of resistance to extended-spectrum cephalosporins. METHODS: A prospective multicentre cohort of patients with infection/colonisation due to pAmpC-producing Enterobacteriaceae was performed in 7 Spanish hospitals from February throughout July 2009. pAmpCs were characterised by PCR and sequencing. RESULTS: 140 patients were included; organisms isolated were Escherichia coli (n = 100), Proteus mirabilis (n = 20), Klebsiella pneumoniae (n = 17), and others (n = 3). Overall, 90% had a chronic underlying condition. The acquisition was nosocomial in 43%, healthcare-associated in 41% (14% of those were nursing home residents), and community in 16%. Only 5% of patients had no predisposing feature for infection with multidrug-resistant bacteria. Nineteen percent of patients were bacteraemic. Inappropriate empirical therapy was administered to 81% of bacteraemic patients, who had a crude mortality rate of 48%. The most frequent enzyme was CMY-2 (70%, predominantly in E. coli and P. mirabilis) followed by DHA-1 (19%, predominantly in K. pneumoniae). CONCLUSION: pAmpC-producing Enterobacteriaceae caused nosocomial, healthcare-associated and community infections mainly in predisposed patients. Invasive infections were associated with high mortality which might be partly related to inappropriate empirical therapy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Farmacorresistência Bacteriana Múltipla / Enterobacteriaceae / Infecções por Enterobacteriaceae Idioma: En Ano de publicação: 2012 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Proteínas de Bactérias / Beta-Lactamases / Farmacorresistência Bacteriana Múltipla / Enterobacteriaceae / Infecções por Enterobacteriaceae Idioma: En Ano de publicação: 2012 Tipo de documento: Article