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 language | English |
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Pages (from-to) | 543-551 |
Number of pages | 9 |
Journal | Respirology |
Volume | 25 |
Issue number | 5 |
DOIs | |
Publication status | Published - 2020 |
Keywords
- community-acquired pneumonia
- Enterobacteriaceae
- multidrug-resistance
- prevalence
- risk factors
- adult
- aged
- antibiotic resistance
- Article
- bacterium culture
- bacterium identification
- body mass
- cardiovascular disease
- cohort analysis
- community acquired pneumonia
- controlled study
- disease severity
- Enterobacteriaceae infection
- Escherichia coli
- extended spectrum beta lactamase producing Enterobacteriaceae
- female
- geographic distribution
- hospital patient
- hospitalization
- human
- Klebsiella pneumoniae
- major clinical study
- male
- multidrug resistant Enterobacteriaceae
- nonhuman
- priority journal
- risk assessment
- risk factor
- sex difference
- underweight