Klebsiella ESBL bacteremia-mortality and risk factors

• Published in: The Brazilian journal of infectious diseases Vol. 15; no. 6; pp. 594 - 598
• Main Authors: Tuon, Felipe Francisco, Kruger, Margot, Terreri, Marcos, Penteado-Filho, Sergio R, Gortz, Lucas
• Format: Journal Article
• Language: English
• Published: Elsevier 01.12.2011
• Subjects: bacteremia; beta-lactamases; carbapenems; Klebsiella pneumoniae
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1590/S1413-86702011000600016

Background: Extended spectrum β-lactamase (ESBL)-producing bacteria have become recognized as a problem in South America. The aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by ESBL-producing Klebsiella pneumoniae in a Brazilian hospital. Methods: A three-year retrospective cohort study with 104 cases of K. pneumoniae bacteremia (61 ESBL and 43 non-ESBL). Several clinical and laboratory variables were evaluated. The outcome of interest was 30-day mortality. The adequate treatment was evaluated according to antibiotic susceptibility. Results: Multivariable analysis showed that central venous catheter and mechanical ventilation were independent risk factors for ESBL. The duration of hospitalization before the bacteremia was not a risk factor. Mortality was similar in ESBL and non-ESBL and inadequate therapy was not shown to be a risk factor. Conclusion: ESBL-producing Klebsiella bacteremia can occur early, suggesting that a carbapenem should be included in the initial empirical therapy for bacteremia in patients under mechanical ventilation and/or central venous catheter in our institution.