Mortality and Risk Factors of Death in Patients with AmpC [beta]-Lactamase Producing Enterobacterales Bloodstream Infection: A Cohort Study

Aim: ESCPM bacteria include Enterobacter spp, Serratia, Citrobacter spp, Providencia spp, and Morganella spp. These Gramnegative bacilli harbor chromosomally encoded AmpC-type [beta]-lactamases that cause resistance to [beta]-lactam antibiotics, such as penicillins, [beta]-lactam/[beta]-lactamase in...

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Published in:Infection and drug resistance 2024-09, Vol.17, p.4023
Main Authors: da Silva, Natalia Chilinque Zambao, Silva, Ana Sheila Duarte Nunes, do Valle, Fernanda Moreth, da Rocha, Jaqueline Abel, Martins, Ianick Souto, Ehrlich, Shelley
Format: Article
Language:English
Subjects:
Bacteria
Beta lactam antibiotics
Beta lactamases
Brazil
Infection
Medical research
Medicine, Experimental
Mortality
Patient outcomes
Risk factors
Septic shock
Tazobactam
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Summary:Aim: ESCPM bacteria include Enterobacter spp, Serratia, Citrobacter spp, Providencia spp, and Morganella spp. These Gramnegative bacilli harbor chromosomally encoded AmpC-type [beta]-lactamases that cause resistance to [beta]-lactam antibiotics, such as penicillins, [beta]-lactam/[beta]-lactamase inhibitors, and first-, second-, and third-generation cephalosporins. Bloodstream infections caused by ESCPM group bacteria (BSI-ESCPM) are difficult to treat. Purpose: To describe 30-day mortality and analyze potential risk factors for death in patients with BSI-ESCPM. Patients and Methods: A cohort study of patients aged [greater than or equal to] 18 years with BSI-ESCPM was conducted at a University Hospital in Brazil, from January 2013 and December 2018. Potential risk factors for death within 30 days of bloodstream infection BSI diagnosis were analyzed using multivariable logistic regression. Results: Among 138 patients with BSI-ESCPM, 63.0% were males, with a median age of 61 years. Of 155 BSI-ESCPM episodes, 61.3% were hospital-acquired. Primary BSI-ESCPM associated with short-term central venous catheter (37.4%) and BSI-ESCPM secondary to respiratory infection (19.4%) occurred mainly. Mostly, Enterobacter spp. (49.7%) and Serratia spp. (29.0%) were isolated. Multidrug-resistance occurred in 27.7% of BSI-ESCPM episodes, involving Enterobacter spp. (16.1%) and Serratia spp. (7.7%) mainly. The mortality was 24.5%. Developing septic shock within 72 h of BSI-ESCPM diagnosis (OR: 70.26; 95% CI: 16.69-295.77; P
ISSN:1178-6973
1178-6973
DOI:10.2147/IDR.S473789