Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Feb 14:6:24.
doi: 10.1186/1471-2334-6-24.

Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum beta-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence

Alexandre R Marra  1 , Sérgio B Wey, Adauto Castelo, Ana Cristina Gales, Ruy Guilherme R Cal, José R do Carmo Filho, Michael B Edmond, Carlos Alberto P Pereira
Affiliations

Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum beta-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence

Alexandre R Marra et al. BMC Infect Dis. .

Abstract

Background: The frequency of ESBL producing Klebsiella pneumoniae bloodstream infections (BSI) is high in Brazilian hospitals, however little is known regarding what role, if any, resistance plays in the expected outcome in hospitals with a high prevalence of these pathogens.

Methods: From 1996 to 2001, hospital acquired K. pneumoniae BSI were evaluated retrospectively. Each patient was included only once at the time of BSI. ESBL producing strains were identified using the E-test method. The association of variables with the mortality related to bacteremia was included in a stepwise logistic regression model.

Results: One hundred and eight hospital acquired K. pneumoniae BSI met criteria for inclusion. Fifty two percent were due to ESBL producing strains. The overall in-hospital mortality was 40.8%. Variables independently predicting death by multivariate analysis were the following: mechanical ventilation (p = 0.001), number of comorbidities (p = 0.003), antimicrobials prescribed before bacteremia (p = 0.01) and fatal underlying disease (p = 0.025).

Conclusion: Bacteremia due to ESBL producing K. pneumoniae strains was not an independent predictor for death in patients with BSI. An increased mortality in hospital-acquired BSI by K. pneumoniae was related to the requirement for mechanical ventilation, more than two comorbidities, the previous use of two or more antibiotics, and the presence of a rapidly fatal disease.

PubMed Disclaimer

References

    1. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control. 1988;16:128–140. doi: 10.1016/0196-6553(88)90053-3. - DOI - PubMed
    1. Pfaller AM, Jones RN, Doern GV, Kugler K. Bacterial pathogens isolated from patients with bloodstream infection: frequencies of occurrence and antimicrobial susceptibility patterns from the SENTRY anti-microbial surveillance program (United States and Canada, 1997) Antimicrob Agents Chemother. 1998;42:1762–1770. - PMC - PubMed
    1. Gales AC, Bolmström A, Sampaio J, Jones RN, Sader HS. Antimicrobial Susceptibility of Klebsiella pneumoniae producing extended-spectrum β-lactamase (ESBL) isolated in hospitals in Brazil. Braz J Infect Dis. 1997;1:196–203. - PubMed
    1. Knothe H, Shah P, Kreméry V, Antal M, Mitsuhashi S. Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens. Infection. 1983;11:315–317. doi: 10.1007/BF01641355. - DOI - PubMed
    1. Quinn JP, Miyashiro D, Sahm D, Flamm R, Bush K. Novel plasmid-mediated betalactamase (TEM-10) conferring selective resistance to ceftazidime and aztreonam in clinical isolates of Klebsiella pneumoniae. Antimicrob Agents Chemother. 1989;33:1451–1456. - PMC - PubMed

MeSH terms

LinkOut - more resources