Risk for primary cephalosporin resistance in Gram-negative bacteremia

Abstract Objective: This study aimed to examine the clinical risk factors for cephalosporin resistance in patients with Gram-negative bacteremia caused by Escherichia coli (EC), Klebsiella pneumoniae (KP), Enterobacter cloacae (ENC), and Pseudomonas aeruginosa (PS). Methods: retrospective cohort included 400 adults bacteremia. The goal was review 100 cases involving each species approximately half resistant susceptible first-line cephalosporins, ceftriaxone (EC or KP), cefepime (ENC PS). Logistic regression used identify predictive of resistance. Results: A total 378 were analysis. Multivariate analysis identified significant resistance, including admission from a chronic care hospital, skilled nursing facility, having history infection within prior 6 months (OR 3.00, P < .0001), requirement mechanical ventilation 3.76, presence hemiplegia 3.54, = .0304), connective tissue disease 3.77, .0291). Conclusions: Patients without should be strongly considered receiving rather than carbapenems newer broad-spectrum agents.