RT Journal Article
SR Electronic
T1 Extended spectrum Beta-lactamase producing Escherichia coli and Klebsiella pneumoniae bacteremia. Risk factors and outcome in the Eastern Region of Saudi Arabia
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 803
OP 808
VO 30
IS 6
A1 Memon, Javed I.
A1 Rehmani, Rifat S.
A1 Ahmed, Mughis U.
A1 Elgendy, Ahmad M.
A1 Nizami, Imran Y.
YR 2009
UL http://smj.org.sa/content/30/6/803.abstract
AB OBJECTIVE: To study the risk factors for bacteremia caused by Escherichia coli (E.coli) or Klebsiella pneumoniae (K.pneumoniae) producing extended-spectrum beta-lactamase (ESBL) and their outcome.METHODS: A case-control study was conducted in King Abdul-Aziz National Guard Hospital, Al-Ahsa, Kingdom of Saudi Arabia from January 2006 through December 2007. All adult patients for whom culture results were positive for E. coli or K. pneumoniae were eligible. Twenty-nine patients with ESBL producing bacteremia (cases) were compared with 80 patients with non-ESBL producing bacteremia controls. Hospital mortality was the primary end point. Univariable and multivariable logistic regression were performed to analyze risk factors for ESBL bacteremia and its 30-day mortality.RESULTS: A total of 109 patients with bacteremia were enrolled that included 29 cases and 80 controls. Forty-nine percent of the patients were male. The mean age was 60.2±21.1 years. Nosocomial infection was the only independent risk factor for bacteremia due to ESBL-producing pathogens (odds ratio [OR] 3.40, 95% confidence interval [CI] 1.14-8.44, p=0.02). Overall 30-day mortality was 22%, and was similar in both groups. The nosocomial infection (OR 3.20, 95% CI 1.48-6.94, p=0.01), presentation with septic shock (OR 48.88, 95% CI 6.01-397.32, p=0.004), and intensive care unit care (OR 7.40, 95% CI 1.94 -28.34, p=0.001) were the independent risk factors for 30-day mortality.CONCLUSION: The ESBL rate is high in our study among the bacteremic patients. Nosocomial infection is identified both as a risk factor for ESBL bacteremia and mortality. The ESBL rate is high in our study among the bacteremic patients. Nosocomial infection is identified both as a risk factor for ESBL bacteremia and mortality.