Prevalence and impact of extended-spectrum beta-lactamase production on clinical outcomes in cancer patients with Enterobacter species bacteremia
The Korean Journal of Internal Medicine
;
: 637-646, 2014.
Article
in English
| WPRIM
| ID: wpr-108337
ABSTRACT
BACKGROUND/AIMS:
We examined the prevalence of extended-spectrum beta-lactamase (ESBL) production and the impact of ESBL on clinical outcomes in cancer patients with Enterobacter spp. bacteremia.METHODS:
Using prospective cohort data on Enterobacter bacteremia obtained between January 2005 and November 2008 from a tertiary care center, the prevalence and clinical impact of ESBL production were evaluated.RESULTS:
Two-hundred and three episodes of Enterobacter spp. bacteremia were identified. Thirty-one blood isolates (15.3%, 31/203) scored positive by the double-disk synergy test. Among 17 isolates in which ESBL genes were detected by polymerase chain reaction and sequencing, CTX-M (n = 12), SHV-12 (n = 11), and TEM (n = 4) were the most prevalent ESBL types. Prior usage of antimicrobial agents (77.4% vs. 54.0%, p = 0.02) and inappropriate empirical antimicrobial therapy (22.6% vs. 3.0%, p < 0.001) were more commonly encountered in the ESBL-positive group than in the extended-spectrum cephalosporin-susceptible ESBL-negative group, respectively. Clinical outcomes did not differ significantly between the two groups (30-day mortality rate, 19.4% vs. 17.0%, p = 0.76; median length of hospital stay, 24.0 days vs. 30.5 days, p = 0.97). Initial presentation of severe sepsis/septic shock, pneumonia, and intra-abdominal infection were independently associated with 30-day mortality.CONCLUSIONS:
The prevalence of ESBL-producing isolates was 15.3% in cancer patients with Enterobacter bacteremia. Although inappropriate empirical therapy was more common in the ESBL-positive group, ESBL production was not associated with poorer outcomes.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Beta-Lactamases
/
Prospective Studies
/
Cohort Studies
/
Treatment Outcome
/
Bacteremia
/
Enterobacter
/
Enterobacteriaceae Infections
/
Anti-Bacterial Agents
/
Neoplasms
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Child
/
Female
/
Humans
/
Infant
/
Male
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2014
Type:
Article
Similar
MEDLINE
...
LILACS
LIS