Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Sakellariou, C; Gürntke, S; Steinmetz, I; Kohler, C; Pfeifer, Y; Gastmeier, P; Schwab, F; Kola, A; Deja, M; Leistner, R.
Sepsis Caused by Extended-Spectrum Beta-Lactamase (ESBL)-Positive K. pneumoniae and E. coli: Comparison of Severity of Sepsis, Delay of Anti-Infective Therapy and ESBL Genotype.
PLoS One. 2016; 11(7): e0158039-e0158039.
Doi: 10.1371/journal.pone.0158039
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- Co-authors Med Uni Graz
- Steinmetz Ivo
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- Abstract:
- Infections with extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) are associated with increased mortality. Outcome differences due to various species of ESBL-E or ESBL genotypes are not well investigated. We conducted a cohort study to assess risk factors for mortality in cases of ESBL-E bacteremia (K. pneumoniae or E. coli) and the risk factors for sepsis with organ failure. All consecutive patients of our institution from 2008 to 2011 with bacteremia due to ESBL-E were included. Basic epidemiological data, underlying comorbidities, origin of bacteremia, severity of sepsis and delay of appropriate anti-infective treatment were collected. Isolates were PCR-screened for the presence of ESBL genes and plasmid-mediated AmpC β-lactamases. Cox proportional hazard regression on mortality and multivariable logistic regression on risk factors for sepsis with organ failure was conducted. 219 cases were included in the analysis: 73.1% due to E. coli, 26.9% due to K. pneumoniae. There was no significant difference in hospital mortality (ESBL-E. coli, 23.8% vs. ESBL-K. pneumoniae 27.1%, p = 0.724). However, the risk of sepsis with organ failure was associated in cases of K. pneumoniae bacteremia (OR 4.5, p<0.001) and patients with liver disease (OR 3.4, p = 0.004) or renal disease (OR 6.8, p<0.001). We found significant differences in clinical presentation of ESBL-E bacteremia due to K. pneumoniae compared to E. coli. As K. pneumoniae cases showed a more serious clinical presentation as E. coli cases and were associated with different risk factors, treatment and prevention strategies should be adjusted accordingly.
- Find related publications in this database (using NLM MeSH Indexing)
- Anti-Bacterial Agents - pharmacology
- Anti-Bacterial Agents - therapeutic use
- Bacteremia - drug therapy
- Bacteremia - microbiology
- Escherichia coli - drug effects
- Escherichia coli - enzymology
- Genotype -
- Hospital Mortality -
- Humans -
- Kaplan-Meier Estimate -
- Klebsiella pneumoniae - drug effects
- Klebsiella pneumoniae - enzymology
- Logistic Models -
- Multiple Organ Failure -
- Multivariate Analysis -
- Proportional Hazards Models -
- Risk Factors -
- Sepsis - drug therapy
- Sepsis - microbiology
- Sepsis - mortality
- Sepsis - pathology
- Severity of Illness Index -
- Survivors -
- beta-Lactamases - genetics