TY - JOUR
T1 - Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia
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.
N1 - Funding Information:
We would like to thank the European Respiratory Society, the World Federation of Societies of Intensive and Critical Care Medicine, the American College of Chest Physicians, the Asociación Latinoamericana de Tórax (ALAT) and the Sociedad Argentina de Infectología (SAI) for supporting this project. N.J.S. is partially funded by the Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative Grant (HX002263‐01A1). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs.
Funding Information:
We would like to thank the European Respiratory Society, the World Federation of Societies of Intensive and Critical Care Medicine, the American College of Chest Physicians, the Asociaci?n Latinoamericana de T?rax (ALAT) and the Sociedad Argentina de Infectolog?a (SAI) for supporting this project. N.J.S. is partially funded by the Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative Grant (HX002263-01A1). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the Department of Veterans Affairs.
Publisher Copyright:
Published 2019. This article is a U.S. Government work and is in the public domain in the USA
PY - 2020/5/1
Y1 - 2020/5/1
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 - Enterobacteriaceae
KW - community-acquired pneumonia
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
C2 - 31385399
AN - SCOPUS:85070513507
SN - 1323-7799
VL - 25
SP - 543
EP - 551
JO - Respirology
JF - Respirology
IS - 5
ER -
