Journal
BRAZILIAN JOURNAL OF INFECTIOUS DISEASES
Volume 15, Issue 6, Pages 594-598Publisher
CONTEXTO
DOI: 10.1590/S1413-86702011000600016
Keywords
Klebsiella pneumoniae; beta-lactamases; bacteremia; carbapenems
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Funding
- MSD
- Pfizer
- Novartis
- United medical
- Merck [IISP 37333]
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Background: Extended spectrum p-lactamase (ESBL)-producing bacteria have become recognized as a problem in South America. The aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by ESBL-producing Klebsiella pneumoniae in a Brazilian hospital. Methods: A three-year retrospective cohort study with 104 cases of K. pneumoniae bacteremia (61 ESBL and 43 non-ESBL). Several clinical and laboratory variables were evaluated. The outcome of interest was 30-day mortality The adequate treatment was evaluated according to antibiotic susceptibility. Results: Multivariable analysis showed that central venous catheter and mechanical ventilation were independent risk factors for ESBL. The duration of hospitalization before the bacteremia was not a risk factor. Mortality was similar in ESBL and non-ESBL and inadequate therapy was not shown to be a risk factor. Conclusion: ESBL-producing Klebsiella bacteremia can occur early, suggesting that a carbapenem should be included in the initial empirical therapy for bacteremia in patients under mechanical ventilation and/or central venous catheter in our institution.
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