TY - JOUR
T1 - Extended-spectrum β-lactamase-producing Enterobacteriaceae in an italian intensive care unit
T2 - Clinical and therapeutical remarks
AU - Carretto, E.
AU - Emmi, V.
AU - Barbarini, D.
AU - Capra Marzani, F.
AU - Bolongaro, A.
AU - Braschi, A.
AU - Marone, P.
PY - 2004/4
Y1 - 2004/4
N2 - 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).
AB - 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).
KW - Enterobacteriaceae
KW - Epidemiology
KW - ESBL
KW - Extended spectrum beta-lactamases
KW - Intensive Care Unit
KW - Proteus mirabilis
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M3 - Article
C2 - 15216948
AN - SCOPUS:2942628342
VL - 16
SP - 145
EP - 150
JO - Journal of Chemotherapy
JF - Journal of Chemotherapy
SN - 1120-009X
IS - 2
ER -