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

Details

• 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.
• Subjects:
  Aged Beta-Lactamases Beta-Lactam Resistance Beta Lactamases Cohort Studies Cross-Sectional Studies Drug-resistance Microbial Drug Resistance, Multiple, Bacterial Escherichia Coli Escherichia Coli Infections Female Humans Intensive Care Units Klebsiella Klebsiella Infections Male Microbial Sensitivity Tests Middle Aged Prospective Studies Research Risk Factors

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• Source:
  Emerg Infect Dis. 13(8):1144-1149.
• Document Type:
  Journal Article
• Volume:
  13
• Issue:
  8
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:cbe43724df7c200c3bed545108fa1a40699a8bf53323fb1659bb3ddb827085ae
• Download URL:
  https://stacks.cdc.gov/view/cdc/16690/cdc_16690_DS1.pdf
• File Type:
  [PDF - 166.96 KB ]