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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060
EISSN: 1678-8060
Vol. 101, No. 4, 2006, pp. 415-421
Bioline Code: oc06074
Full paper language: English
Document type: Research Article
Document available free of charge

Memórias do Instituto Oswaldo Cruz, Vol. 101, No. 4, 2006, pp. 415-421

 en Clinical outcome and risk factors related to extended-spectrum beta-lactamase-producing Klebsiella check for this species in other resources spp. infection among hospitalized patients
Fernando Bellíssimo-Rodrigues; Ana Carolina Frade Gomes; Afonso Dinis Costa Passos; Jorge Alberto Achcar; Gleici da Silva Castro Perdoná & Roberto Martinez

Abstract

Over the past two decades, nosocomial infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella check for this species in other resources spp. have become a major problem all around the world. This situation is of concern because there are limited antimicrobial options to treat patients infected with these pathogens, and also because this kind of resistance can spread to a wide variety of Gram-negative bacilli. Our objectives were to evaluate among in-patients at a public university tertiary-care hospital with documented infection due to Klebsiella spp., which were the risk factors (cross-sectional analysis) and the clinical impact (prospective cohort) associated with an ESBL-producing strain. Study subjects were all patients admitted at the study hospital between April 2002 and October 2003, with a clinically and microbiologically confirmed infection caused by Klebsiella spp. at any body site, except infections restricted to the urinary tract. Of the 104 patients studied, 47 were infected with an ESBL-producing strain and 57 with a non-ESBL-producing strain. Independent risk factors associated with infection with an ESBL-producing strain were young age, exposure to mechanical ventilation, central venous catheter, use of any antimicrobial agent, and particularly use of a 4th generation cephalosporin or a quinolone. Length of stay was significant longer for patients infected with ESBL-producing strains than for those infected with non-ESBL-producing strains, although fatality rate was not significantly affected by ESBL-production in this cohort. In fact, mechanical ventilation and bacteremia were the only variables with independent association with death detected in this investigation.

Keywords
extended-spectrum beta-lactamase - Klebsiella spp. - risk factors - clinical outcome

 
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