Extended-spectrum β-lactamase-producing Enterobacteriaceae in an italian intensive care unit: Clinical and therapeutical remarks

E. Carretto, V. Emmi, D. Barbarini, F. Capra Marzani, A. Bolongaro, A. Braschi, P. Marone

Research output: Contribution to journalArticlepeer-review

Abstract

In this study we evaluated the prevalence of Enterobacteriaceae and the epidemiology of ESBL+microorganisms in an ICU of our Institution over a 5-year period and analyzed the clinical features and outcomes of the infections caused by these microorganisms. The most frequent ESBL+ isolate was Proteus mirabilis (69 isolates, 58%); a high rate of positive results in the double-disk synergy test (DDS) was also recognized for Klebsiella pneumoniae (52 isolates, 51%), whereas this phenomenon was observed less frequently in other species. In 312 cases the isolated microorganism was considered to be the cause of infection; we documented 103 wound infections, 89 UTIs, 62 LRTIs, 30 primary bacteremias, 27 infections of indwelling catheters and 1 CNS infection. The overall mortality rate due to ESBL+ strains was 1%, compared with 10.6% rate caused by ESBL-negative Enterobacteriaceae. This could be explained because ESBL+ strains caused mostly localized infections (wound infections and UTIs), whereas systemic or severe infections were sustained by ESBL-negative strains, and therapy with carbapenems was started promptly after ESBL+ isolation (always within 24h after strain isolation).

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalJournal of Chemotherapy
Volume16
Issue number2
Publication statusPublished - Apr 2004

Keywords

  • Enterobacteriaceae
  • Epidemiology
  • ESBL
  • Extended spectrum beta-lactamases
  • Intensive Care Unit
  • Proteus mirabilis

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Microbiology (medical)

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