Journal Article

Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae:</i> Risk Factors for Infection and Impact of Resistance on Outcomes

Ebbing Lautenbach, Jean Baldus Patel, Warren B. Bilker, Paul H. Edelstein and Neil O. Fishman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 32, issue 8, pages 1162-1171
Published in print April 2001 | ISSN: 1058-4838
Published online April 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/319757
Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae: Risk Factors for Infection and Impact of Resistance on Outcomes

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The prevalence of antibiotic resistance among extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae has increased markedly in recent years. Thirty-three patients with infection due to ESBL-producing E. coli or K. pneumoniae (case patients) were compared with 66 matched controls. Total prior antibiotic use was the only independent risk factor for ESBL-producing E. coli or K. pneumoniae infection (odds ratio, 1.10; 95% confidence interval, 1.03–1.18; P = .006). Case patients were treated with an effective antibiotic a median of 72 hours after infection was suspected, compared with a median of 11.5 hours after infection was suspected for controls (P < .001). ESBL-producing E. coli or K. pneumoniae infection was associated with a significantly longer duration of hospital stay and greater hospital charges (P = .01 and P < .001, respectively). Finally, many ESBL-producing E. coli and K. pneumoniae isolates were closely related. ESBL-producing E. coli and K. pneumoniae infections have a significant impact on several important clinical outcomes, and efforts to control outbreaks of infection with ESBL-producing E. coli and K. pneumoniae should emphasize judicious use of all antibiotics as well as barrier precautions to reduce spread.

Journal Article.  5546 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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