- Infection
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Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit
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Bumjoon Kim, Sung Gyun Kim, Seung Soon Lee, Tae Seok Kim, Yong Il Hwang, Seung Hun Jang, Joo Hee Kim, Ki Suck Jung, Sunghoon Park
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Korean J Crit Care Med. 2014;29(4):257-265. Published online November 30, 2014
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DOI: https://doi.org/10.4266/kjccm.2014.29.4.257
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 Abstract
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- BACKGROUND
The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting.
METHODS
Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome.
RESULTS
In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs.
10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production.
CONCLUSIONS
Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.
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Citations
Citations to this article as recorded by  - Worrisome high frequency of extended-spectrum beta-lactamase-producing Escherichia coli in community-acquired urinary tract infections: a case–control study
Franco Castillo-Tokumori, Claudia Irey-Salgado, Germán Málaga
International Journal of Infectious Diseases.2017; 55: 16. CrossRef
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