Brazilian Journal of Infectious Diseases
Print version ISSN 1413-8670
SEREFHANOGLU, Kivanc; TURAN, Hale; TIMURKAYNAK, Funda Ergin and ARSLAN, Hande. Bloodstream infections caused by ESBL-producing E. Coli and K. pneumoniae: risk factors for multidrug-resistance. Braz J Infect Dis [online]. 2009, vol.13, n.6, pp. 403-407. ISSN 1413-8670. http://dx.doi.org/10.1590/S1413-86702009000600003.
This prospective case-control study was conducted from October 2003 to June 2007 to evaluate risk factors for multidrug resistance among extended-spectrum-b-lactamase-producing Escherichia coli and Klebsiella spp. (ESBL-EK) isolates in blood cultures. All adult patients (>18 years old) whose blood cultures grew ESBL-EK during the study period were included. An ESBL-EK isolate was defined as MDR if it was resistant to at least one member of following two classes of antibiotics: aminoglycosides (amikacin, gentamicin, or netilmycin) and fluoroquinolones (ofloxacin, or ciprofloxacin). Case patients were those with a MDR ESBL-EK isolate, and control patients were those with a non-MDR ESBL-EK isolate. A total of 94 bloodstream infections, including 37 (39,4%) bloodstream infections with ESBL-producing E. coli and 57 (60,6%) with ESBL-producing K. pneumoniae,in 86 patients were enrolled. Thirty episodes (31.9%) were due to MDR ESBL-EK. The only independent risk factor for MDR ESBL-EK was duration of hospitalization before bacteraemia (OR 3.88; 95% CI 1.55-9.71; p=0.004). The rate of multidrug resistance among ESBL-EK bloodstream isolates was high, and duration of hospitalization before bacteraemia was the only indeepended risk factor for the MDR ESBL-EK bloodstream infections.
Keywords : ESBLs; multidrug resistance; risk factors.