Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

GLIMP investigators

Research output: Contribution to journalArticle

Abstract

Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

Original languageEnglish
JournalRespirology
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Enterobacteriaceae
Pneumonia
Thinness
beta-Lactamases
Enterobacteriaceae Infections
Infection
Klebsiella pneumoniae
Hospitalization
Body Mass Index

Keywords

  • community-acquired pneumonia
  • Enterobacteriaceae
  • multidrug-resistance
  • prevalence
  • risk factors

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia. / GLIMP investigators.

In: Respirology, 01.01.2019.

Research output: Contribution to journalArticle

@article{ee2cf657d221493589e89b5070293de8,
title = "Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia",
abstract = "Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6{\%}) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19{\%} (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56{\%}) and Escherichia coli (n = 56, 28{\%}). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6{\%} and MDR-EB of 1.2{\%}, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.",
keywords = "community-acquired pneumonia, Enterobacteriaceae, multidrug-resistance, prevalence, risk factors",
author = "{GLIMP investigators} and David Villafuerte and Stefano Aliberti and Soni, {Nilam J.} and Paola Faverio and Marcos, {Pedro J.} and Wunderink, {Richard G.} and Alejandro Rodriguez and Oriol Sibila and Francisco Sanz and Ignacio Martin-Loeches and Francesco Menzella and Reyes, {Luis F.} and Mateja Jankovic and Marc Spielmanns and Restrepo, {Marcos I.} and Aruj, {Patricia Karina} and Silvia Attorri and Enrique Barimboim and Caeiro, {Juan Pablo} and Garz{\'o}n, {Mar{\'i}a I.} and Cambursano, {Victor Hugo} and Adrian Ceccato and Julio Chertcoff and {Cordon D{\'i}az}, Ariel and {de Vedia}, Lautaro and Ganaha, {Maria Cristina} and Sandra Lambert and Gustavo Lopardo and Luna, {Carlos M.} and Malberti, {Alessio Gerardo} and Nora Morcillo and Silvina Tartara and Claudia Pensotti and Betiana Pereyra and Scapellato, {Pablo Gustavo} and Stagnaro, {Juan Pablo} and Sonali Shah and Felix L{\"o}tsch and Florian Thalhammer and Kurt Anseeuw and Francois, {Camille A.} and {Van Braeckel}, Eva and Vincent, {Jean Louis} and Djimon, {Marcel Zannou} and Nou{\'e}r, {Simone Aranha} and Peter Chipev and Maria Carrabba and Piero Ceriana and Paolo Rossi and Mauro Carone",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/resp.13663",
language = "English",
journal = "Respirology",
issn = "1323-7799",
publisher = "Wiley-Blackwell",

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TY - JOUR

T1 - Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

AU - GLIMP investigators

AU - Villafuerte, David

AU - Aliberti, Stefano

AU - Soni, Nilam J.

AU - Faverio, Paola

AU - Marcos, Pedro J.

AU - Wunderink, Richard G.

AU - Rodriguez, Alejandro

AU - Sibila, Oriol

AU - Sanz, Francisco

AU - Martin-Loeches, Ignacio

AU - Menzella, Francesco

AU - Reyes, Luis F.

AU - Jankovic, Mateja

AU - Spielmanns, Marc

AU - Restrepo, Marcos I.

AU - Aruj, Patricia Karina

AU - Attorri, Silvia

AU - Barimboim, Enrique

AU - Caeiro, Juan Pablo

AU - Garzón, María I.

AU - Cambursano, Victor Hugo

AU - Ceccato, Adrian

AU - Chertcoff, Julio

AU - Cordon Díaz, Ariel

AU - de Vedia, Lautaro

AU - Ganaha, Maria Cristina

AU - Lambert, Sandra

AU - Lopardo, Gustavo

AU - Luna, Carlos M.

AU - Malberti, Alessio Gerardo

AU - Morcillo, Nora

AU - Tartara, Silvina

AU - Pensotti, Claudia

AU - Pereyra, Betiana

AU - Scapellato, Pablo Gustavo

AU - Stagnaro, Juan Pablo

AU - Shah, Sonali

AU - Lötsch, Felix

AU - Thalhammer, Florian

AU - Anseeuw, Kurt

AU - Francois, Camille A.

AU - Van Braeckel, Eva

AU - Vincent, Jean Louis

AU - Djimon, Marcel Zannou

AU - Nouér, Simone Aranha

AU - Chipev, Peter

AU - Carrabba, Maria

AU - Ceriana, Piero

AU - Rossi, Paolo

AU - Carone, Mauro

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

AB - Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

KW - community-acquired pneumonia

KW - Enterobacteriaceae

KW - multidrug-resistance

KW - prevalence

KW - risk factors

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UR - http://www.scopus.com/inward/citedby.url?scp=85070513507&partnerID=8YFLogxK

U2 - 10.1111/resp.13663

DO - 10.1111/resp.13663

M3 - Article

JO - Respirology

JF - Respirology

SN - 1323-7799

ER -