Prevalence and impact of extended-spectrum β-lactamase production on clinical outcomes in cancer patients with Enterobacter species bacteremia
نویسندگان
چکیده
BACKGROUND/AIMS We examined the prevalence of extended-spectrum β-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.
منابع مشابه
Prevalence of Multiple Drug Resistant Clinical Isolates of Extended-Spectrum Beta-Lactamase Producing Enterobacteriaceae in Southeast Iran
Background: Multidrug resistance and production of extended spectrum β-lactamases (ESBLs) by enteric gram-negative rods in hospitals and community continue to be worsened. We aimed to characterize the multidrug resistance and determine the prevalence of ESBL production by clinical isolates of Enterobacteriaceae in southeast Iran. Methods: Gram-negative bacteria isolated from clinical samples of...
متن کاملPrevalence of Extended-Spectrum β-lactamase and Integron Gene Carriage in Multidrug-Resistant Klebsiella Species Isolated from Outpatients in Yazd, Iran
Background: Community-acquired infections by multidrug-resistant (MDR), extended-spectrum β-lactamase (ESBL) producing Klebsiella species (Klebsiella spp.) is of major concern worldwide. Antibiotic resistance, production of extended-spectrum β-lactamases (ESBLs), and carbapenemases, as well as the presence of classes 1, 2, and 3 integrons in outpatient isolates of Klebsiella collected from Yazd...
متن کاملبررسی مقاومت دارویی ناشی از بتالاکتاماز وسیع الطیف(ESBL)در کلبسیلاپنومونیه با مقاومت دارویی چندگانه در بیماران بستری
Background: Klebsiella pneumoniae is one of the most important and prevalent bacterium isolated from clinical cases especially from hospitalized patients. Recent studies have focused on multiple drug resistant K.pneumoniae strains. In this survey, drug resistance in clinical isolates was studied with special reference to extended spectrum β-lactamase. Methods: A total of 303 K.pneumoniae strai...
متن کاملPrevalence of Extended-Spectrum Beta-Lactamases Enzymes in Enterobacter Aerogenes Isolated from Urinary Tract Infections in Shahrekord City
Introduction: Enterobacteriaceae produce the Extended-Spectrum Beta-Lactamases which is considered as an important resistant mechanism of beta-lactam antibiotics. The resistance to beta-lactam antibiotics is the main problem in the bacterial infections therapy. The prevalence of these enzymes changes in different geographical areas and with time. The present study aims to explore the frequency ...
متن کاملPrevalence and Antibiotic Resistance Pattern of Extended Spectrum β-Lactamase- (ESBL-) Producing Gram Negative Bacilli isolated from Clinical Samples of hospitalized Patients in a hospital in Gorgan
Background & Aim: Antibiotic resistance among gram-negative bacilli is currently one of the major challenges for the health system in developing countries. The aim of this study was to determine the frequency and antibiotic resistance pattern of common ESBL-producing gram negative bacilli isolated from clinical specimens of hospitalized patients in Falsafi Hospital in Gorgan. Methods: In this ...
متن کامل