Kuster, S P; Hasse, B; Huebner, V; Bansal, V; Zbinden, R; Ruef, C; Ledergerber, B; Weber, R (2010). Risks factors for infections with extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care university hospital in Switzerland. Infection, 38(1):33-40.
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BACKGROUND: There are considerable geographical differences in the occurrence of extended-spectrum beta-lactamase(ESBL)-producing bacteria, both in the community and in the hospital setting. Our aim was to assess risk factors for blood stream, urinary tract, and vascular catheter-associated infections with ESBL-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care hospital in a low-prevalence country. METHODS: We performed a case-control study comparing 58 patients with infections due to ESBL-producing E. coli orK. pneumoniae vs 116 controls with infections due to non-ESBL producing organisms at the University Hospital Zurich, Switzerland, between 1 July 2005 and 30 June 2007. RESULTS: Cases included 15 outpatients and 43 inpatients. Multivariable analyses found three risk factors for ESBL-producing isolates: begin of symptoms or recent antibiotic pre-treatment in a foreign country (odds ratio [OR] 27.01,95% confidence interval [CI] 2.38-1,733.28], p = 0.042),antibiotic therapy within the year preceding the isolation of the ESBL-producing strain (OR 2.88, 95% CI 1.13-8.49,p = 0.025), and mechanical ventilation (OR 10.56, 95% CI 1.06-579.10, p = 0.042). CONCLUSIONS: The major risk factors for infections due to ESBL-producing bacteria were travel in high-prevalence countries, prior antibiotic use, and mechanical ventilation during a stay in the intensive care unit. Community-acquired infections were documented in 17% of the patients.An early identification of risk factors is crucial to providing the patients an optimal empiric antibiotic therapy and to keep the use of carbapenems to a minimum.
|Item Type:||Journal Article, refereed, original work|
|Communities & Collections:||04 Faculty of Medicine > Institute of Medical Microbiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
|Dewey Decimal Classification:||570 Life sciences; biology
610 Medicine & health
|Deposited On:||16 Jan 2011 11:07|
|Last Modified:||28 Nov 2013 01:07|
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