Journal Article

Spread of Extended-Spectrum β-Lactamase—Producing Klebsiella pneumoniae: Are β-Lactamase Inhibitors of Therapeutic Value?

Lionel Piroth, Hervé Aubé, Jean-Marc Doise and Michel Vincent Martin

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 1, pages 76-80
Published in print July 1998 | ISSN: 1058-4838
Published online July 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514643
Spread of Extended-Spectrum β-Lactamase—Producing Klebsiella pneumoniae: Are β-Lactamase Inhibitors of Therapeutic Value?

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Because of recurrent colonization by Klebsiella pneumoniae strains producing type SHV-4 extended-spectrum β-lactamases (ESBLs), a case-control study was conducted in an intensive care unit to investigate the risk of acquisition, with special reference to antibiotic therapy and resuscitation procedures. Fifty-one patients colonized or infected by ESBL-producing K. pneumoniae (cases) were matched with 51 noncolonized patients (controls). Duration of intubation was significantly longer for cases than for controls, while duration of β-lactamase inhibitor therapy was significantly shorter. By means of multivariate analysis, intubation was the only risk factor identified (odds ratio [OR] = 1.19), while β-lactamase inhibitor therapy was shown to be a protective factor (OR = 0.849). During outbreaks of SHV-4 type ESBL—producing K. pneumoniae in intensive care units, preferential use of b-lactamase inhibitors may help control the emergence and spread of these pathogens even if essential hand washing and isolation procedures are adhered to.

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

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