Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission

Harris, Anthony D.; McGregor, Jessina C.; Johnson, Judith A.; Strauss, Sandra M.; Moore, Anita C.; Standiford, Harold C.; Hebden, Joan N.; Morris, J. Glenn

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Risk Factors for Colonization with Extended-Spectrum β-Lactamase–producing Bacteria and Intensive Care Unit Admission

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Aug 2007
By Harris, Anthony D. ; McGregor, Jessina C. ; Johnson, Judith A.

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Alternative Title:

Emerg Infect Dis
Personal Author:

Harris, Anthony D. ; McGregor, Jessina C. ; Johnson, Judith A. ; Strauss, Sandra M. ; Moore, Anita C. ; Standiford, Harold C. ; Hebden, Joan N. ; Morris, J. Glenn
Description:

Extended-spectrum beta-lactamase (ESBL)-producing bacteria are emerging pathogens. To analyze risk factors for colonization with ESBL-producing bacteria at intensive care unit (ICU) admission, we conducted a prospective study of a 3.5-year cohort of patients admitted to medical and surgical ICUs at the University of Maryland Medical Center. Over the study period, admission cultures were obtained from 5,209 patients. Of these, 117 were colonized with ESBL-producing Escherichia coli and Klebsiella spp., and 29 (25%) had a subsequent ESBL-positive clinical culture. Multivariable analysis showed the following to be statistically associated with ESBL colonization at admission: piperacillin-tazobactam (odds ratio OR 2.05, 95% confidence interval CI 1.36-3.10), vancomycin (OR 2.11, 95% CI 1.34-3.31), age > 60 years (OR 1.79, 95% CI 1.24-2.60), and chronic disease score (OR 1.15; 95% CI 1.04-1.27). Coexisting conditions and previous antimicrobial drug exposure are thus predictive of colonization, and a large percentage of these patients have subsequent positive clinical cultures for ESBL-producing bacteria.
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Source:

Emerg Infect Dis. 13(8):1144-1149.
Document Type:

Journal Article
Volume:

13
Issue:

8
Download URL:

https://stacks.cdc.gov/view/cdc/16690/cdc_16690_DS1.pdf
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[PDF - 166.96 KB]
Collection(s):

Emerging Infectious Diseases
Main Document Checksum:

urn:sha256:cbe43724df7c200c3bed545108fa1a40699a8bf53323fb1659bb3ddb827085ae

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