E. Lautenbach et al., Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiellapneumoniae: Risk factors for infection and impact of resistance on outcomes, CLIN INF D, 32(8), 2001, pp. 1162-1171
The prevalence of antibiotic resistance among extended-spectrum beta -lacta
mase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae has increa
sed markedly in recent years. Thirty-three patients with infection due to E
SBL-producing E. coli or K. pneumoniae (case patients) were compared with 6
6 matched controls. Total prior antibiotic use was the only independent ris
k factor for ESBL-producing E, coli or K. pneumoniae infection (odds ratio,
1.10; 95% confidence interval, 1.03-1.18; P = .006). Case patients were tr
eated with an effective antibiotic a median of 72 hours after infection was
suspected, compared with a median of 11.5 hours after infection was suspec
ted for controls (P < .001). ESBL-producing E. coli or K, pneumoniae infect
ion was associated with a significantly longer duration of hospital stay an
d greater hospital charges (P = .01 and P < .001, respectively). Finally, m
any ESBL-producing E. coli and K, pneumoniae isolates were closely related.
ESBL-producing E. coli and K. pneumoniae infections have a significant imp
act on several important clinical outcomes, and efforts to control outbreak
s of infection with ESBL-producing E. coli and K. pneumoniae should emphasi
ze judicious use of all antibiotics as well as barrier precautions to reduc
e spread.