OBJECTIVE: To describe the impact of empiric appropriate treatment and the risk factors associated with mortality in patients with bacteremia by E. coli, K. pneumoniae and P. mirabilis producing ESBL. METHODS: Data were reviewed in an 8-year retrospective study, and 128 bacteremias were found: 80 caused by E. coli (62.5%), 28 by K. pneumoniae (21.9%) and 20 by P. mirabilis (18.6%). RESULTS: The initial antibiotic treatment, administered within 72 h after the first positive blood culture, was appropriate with carbapenems or other antimicrobial agents with documented in vitro sensitivity in 53.8 and 16% of patients, respectively. The overall mortality 21 days after diagnosis was 17.2%, and it was 14.9 and 35.2% for patients adequately and inadequately treated, respectively. At univariate analysis the p value for mortality with and without appropriate treatment was 0.05, and significant differences were found only for previous positive blood cultures (p = 0.004) and presence of septic shock at diagnosis (p = 0.006). CONCLUSION: In this case series there was a high rate of initial appropriate empiric treatment, and only a marginal impact on mortality was found with regard to appropriate and inappropriate treatment. This report shows that the knowledge of ESBL-producing characteristics varies widely among the different case series for reasons that still have to be clarified.
OBJECTIVE: To describe the impact of empiric appropriate treatment and the risk factors associated with mortality in patients with bacteremia by E. coli, K. pneumoniae and P. mirabilis producing ESBL. METHODS: Data were reviewed in an 8-year retrospective study, and 128 bacteremias were found: 80 caused by E. coli (62.5%), 28 by K. pneumoniae (21.9%) and 20 by P. mirabilis (18.6%). RESULTS: The initial antibiotic treatment, administered within 72 h after the first positive blood culture, was appropriate with carbapenems or other antimicrobial agents with documented in vitro sensitivity in 53.8 and 16% of patients, respectively. The overall mortality 21 days after diagnosis was 17.2%, and it was 14.9 and 35.2% for patients adequately and inadequately treated, respectively. At univariate analysis the p value for mortality with and without appropriate treatment was 0.05, and significant differences were found only for previous positive blood cultures (p = 0.004) and presence of septic shock at diagnosis (p = 0.006). CONCLUSION: In this case series there was a high rate of initial appropriate empiric treatment, and only a marginal impact on mortality was found with regard to appropriate and inappropriate treatment. This report shows that the knowledge of ESBL-producing characteristics varies widely among the different case series for reasons that still have to be clarified.
Authors: Jesús Rodríguez-Baño; Maria D Navarro; Luisa Romero; Miguel A Muniain; Marina de Cueto; María J Ríos; José R Hernández; Alvaro Pascual Journal: Clin Infect Dis Date: 2006-10-25 Impact factor: 9.079
Authors: David L Paterson; Wen-Chien Ko; Anne Von Gottberg; Sunita Mohapatra; Jose Maria Casellas; Herman Goossens; Lutfiye Mulazimoglu; Gordon Trenholme; Keith P Klugman; Robert A Bonomo; Louis B Rice; Marilyn M Wagener; Joseph G McCormack; Victor L Yu Journal: Clin Infect Dis Date: 2004-06-08 Impact factor: 9.079
Authors: G Chapelet; A S Boureau; A Dylis; G Herbreteau; S Corvec; E Batard; G Berrut; L de Decker Journal: Eur J Clin Microbiol Infect Dis Date: 2017-08-12 Impact factor: 3.267
Authors: E-J Joo; D A Park; N R Lee; S-Y Moon; J-K Choi; J-H Ko; K R Peck Journal: Eur J Clin Microbiol Infect Dis Date: 2017-06-23 Impact factor: 3.267
Authors: Florine N J Frakking; Wouter C Rottier; J Wendelien Dorigo-Zetsma; Jarne M van Hattem; Babette C van Hees; Jan A J W Kluytmans; Suzanne P M Lutgens; Jan M Prins; Steven F T Thijsen; Annelies Verbon; Bart J M Vlaminckx; James W Cohen Stuart; Maurine A Leverstein-van Hall; Marc J M Bonten Journal: Antimicrob Agents Chemother Date: 2013-04-22 Impact factor: 5.191
Authors: Benoit Pilmis; Vincent Jullien; Alexis Tabah; Jean-Ralph Zahar; Christian Brun-Buisson Journal: Ann Intensive Care Date: 2017-11-10 Impact factor: 6.925