Empirical treatment and mortality in bacteremia due to extended spectrum [beta]-lactamase producing Enterobacterales , a retrospective cross-sectional study in a tertiary referral hospital from Colombia
Background Infections caused by extended spectrum [beta]-lactamase (ES[beta]L) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducte...
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Veröffentlicht in: | Annals of clinical microbiology and antimicrobials 2023-02, Vol.22 (1) |
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creator | Arias Ramos, Deving Alzate, John Alexander Moreno Gómez, Germán Alberto Hoyos Pulgarín, Julián Andrés Olaya Gómez, Juan Camilo Cortés Bonilla, Isabella Vargas Mosquera, Camila |
description | Background Infections caused by extended spectrum [beta]-lactamase (ES[beta]L) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum [beta]-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. Results The prevalence of bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). Conclusions bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes. Keywords: Bacteremia, Antimicrobial resistance, Extended spectrum [beta]-lactamase (ES[beta]L) |
doi_str_mv | 10.1186/s12941-023-00566-2 |
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When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum [beta]-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. Results The prevalence of bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). Conclusions bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes. Keywords: Bacteremia, Antimicrobial resistance, Extended spectrum [beta]-lactamase (ES[beta]L)</description><identifier>ISSN: 1476-0711</identifier><identifier>EISSN: 1476-0711</identifier><identifier>DOI: 10.1186/s12941-023-00566-2</identifier><language>eng</language><publisher>BioMed Central Ltd</publisher><subject>Bacteremia ; Beta lactamases ; Care and treatment ; Development and progression ; Distribution ; Dosage and administration ; Drug resistance in microorganisms ; Forecasts and trends ; Hospital patients ; Mortality ; Prevention</subject><ispartof>Annals of clinical microbiology and antimicrobials, 2023-02, Vol.22 (1)</ispartof><rights>COPYRIGHT 2023 BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Arias Ramos, Deving</creatorcontrib><creatorcontrib>Alzate, John Alexander</creatorcontrib><creatorcontrib>Moreno Gómez, Germán Alberto</creatorcontrib><creatorcontrib>Hoyos Pulgarín, Julián Andrés</creatorcontrib><creatorcontrib>Olaya Gómez, Juan Camilo</creatorcontrib><creatorcontrib>Cortés Bonilla, Isabella</creatorcontrib><creatorcontrib>Vargas Mosquera, Camila</creatorcontrib><title>Empirical treatment and mortality in bacteremia due to extended spectrum [beta]-lactamase producing Enterobacterales , a retrospective cross-sectional study in a tertiary referral hospital from Colombia</title><title>Annals of clinical microbiology and antimicrobials</title><description>Background Infections caused by extended spectrum [beta]-lactamase (ES[beta]L) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum [beta]-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. Results The prevalence of bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). Conclusions bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes. Keywords: Bacteremia, Antimicrobial resistance, Extended spectrum [beta]-lactamase (ES[beta]L)</description><subject>Bacteremia</subject><subject>Beta lactamases</subject><subject>Care and treatment</subject><subject>Development and progression</subject><subject>Distribution</subject><subject>Dosage and administration</subject><subject>Drug resistance in microorganisms</subject><subject>Forecasts and trends</subject><subject>Hospital patients</subject><subject>Mortality</subject><subject>Prevention</subject><issn>1476-0711</issn><issn>1476-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNptkM9KAzEQxhdRUKsv4GnAq6vJbje7PZZS_0DBS28iMptMamSTlCQr9hV9KmP14EFyyGT4fl9mvqK44Oya807cRF7NprxkVV0y1ghRVgfFCZ-2omQt54d_6uPiNMY3xirGRHtSfC7t1gQjcYAUCJMllwCdAutDwsGkHRgHPcpEgaxBUCNB8kAfiZwiBXFLMoXRwlNPCZ_LIUvRYiTYBq9GadwGli7T_scEB4pwBQiBUvB72rwTyFzHMn6_vMvDxDSq_dcIGUoGwy4TmkI2gNfMmTwd6OAtLPzgbW_wrDjSOEQ6_70nxfp2uV7cl6vHu4fFfFVuRM5AIq9Fz3ts-i4nQBVKJaRSXFRCqbabdrqbEpISVdOQ7kg0mtp-xutZpTliPSkuf2w3eZUX47RPAaU1Ub7M27oVXDRcZNX1P6p8VE5Rekfa5P4f4AvaNJCW</recordid><startdate>20230216</startdate><enddate>20230216</enddate><creator>Arias Ramos, Deving</creator><creator>Alzate, John Alexander</creator><creator>Moreno Gómez, Germán Alberto</creator><creator>Hoyos Pulgarín, Julián Andrés</creator><creator>Olaya Gómez, Juan Camilo</creator><creator>Cortés Bonilla, Isabella</creator><creator>Vargas Mosquera, Camila</creator><general>BioMed Central Ltd</general><scope/></search><sort><creationdate>20230216</creationdate><title>Empirical treatment and mortality in bacteremia due to extended spectrum [beta]-lactamase producing Enterobacterales , a retrospective cross-sectional study in a tertiary referral hospital from Colombia</title><author>Arias Ramos, Deving ; Alzate, John Alexander ; Moreno Gómez, Germán Alberto ; Hoyos Pulgarín, Julián Andrés ; Olaya Gómez, Juan Camilo ; Cortés Bonilla, Isabella ; Vargas Mosquera, Camila</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g676-ca136b1ba5b8067e2acd6cdd1626dd7848f84eaed6255ef8e65fe7b91392f1aa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Bacteremia</topic><topic>Beta lactamases</topic><topic>Care and treatment</topic><topic>Development and progression</topic><topic>Distribution</topic><topic>Dosage and administration</topic><topic>Drug resistance in microorganisms</topic><topic>Forecasts and trends</topic><topic>Hospital patients</topic><topic>Mortality</topic><topic>Prevention</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arias Ramos, Deving</creatorcontrib><creatorcontrib>Alzate, John Alexander</creatorcontrib><creatorcontrib>Moreno Gómez, Germán Alberto</creatorcontrib><creatorcontrib>Hoyos Pulgarín, Julián Andrés</creatorcontrib><creatorcontrib>Olaya Gómez, Juan Camilo</creatorcontrib><creatorcontrib>Cortés Bonilla, Isabella</creatorcontrib><creatorcontrib>Vargas Mosquera, Camila</creatorcontrib><jtitle>Annals of clinical microbiology and antimicrobials</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arias Ramos, Deving</au><au>Alzate, John Alexander</au><au>Moreno Gómez, Germán Alberto</au><au>Hoyos Pulgarín, Julián Andrés</au><au>Olaya Gómez, Juan Camilo</au><au>Cortés Bonilla, Isabella</au><au>Vargas Mosquera, Camila</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Empirical treatment and mortality in bacteremia due to extended spectrum [beta]-lactamase producing Enterobacterales , a retrospective cross-sectional study in a tertiary referral hospital from Colombia</atitle><jtitle>Annals of clinical microbiology and antimicrobials</jtitle><date>2023-02-16</date><risdate>2023</risdate><volume>22</volume><issue>1</issue><issn>1476-0711</issn><eissn>1476-0711</eissn><abstract>Background Infections caused by extended spectrum [beta]-lactamase (ES[beta]L) producing bacteria are common and problematic. When they cause bloodstream infections, they are associated with significant morbidity and mortality. Methods A retrospective cross-sectional observational study was conducted in a single center in Pereira, Colombia. It included people hospitalized with bacteremia due to gram-negative bacilli with the extended-spectrum [beta]-lactamase producing phenotype. A logistic regression analysis was constructed. Clinical characteristics and risk factors for death from sepsis were established. Results The prevalence of bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype was 17%. 110 patients were analyzed. Most patients were men (62%) with a median age of 58 years, hospital mortality was 38%. Admission to intensive care was 45%. The following risk factors for mortality were established: shock requiring vasoactive support, Pitt score > 3 points, and not having an infectious disease consultation (IDC). Conclusions bacteremia due to Enterobacterales with extended-spectrum [beta]-lactamase producing phenotype have a high mortality. Early recognition of sepsis, identification of risk factors for antimicrobial resistance, and prompt initiation of appropriate empiric antibiotic treatment are important. An infectious disease consultation may help improve outcomes. Keywords: Bacteremia, Antimicrobial resistance, Extended spectrum [beta]-lactamase (ES[beta]L)</abstract><pub>BioMed Central Ltd</pub><doi>10.1186/s12941-023-00566-2</doi></addata></record> |
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subjects | Bacteremia Beta lactamases Care and treatment Development and progression Distribution Dosage and administration Drug resistance in microorganisms Forecasts and trends Hospital patients Mortality Prevention |
title | Empirical treatment and mortality in bacteremia due to extended spectrum [beta]-lactamase producing Enterobacterales , a retrospective cross-sectional study in a tertiary referral hospital from Colombia |
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