Bloodstream infection due to extended-spectrum beta-lactamase (ESBL)-positive K. pneumoniae and E. coli: an analysis of the disease burden in a large cohort

Purpose The burden of extended-spectrum beta-lactamase (ESBL)-positive Enterobacteriaceae (ESBL-E) is growing worldwide. We aimed to determine the financial disease burden attributable to ESBL-positive species in cases of bloodstream infection (BSI) due to K. pneumoniae and E. coli . Methods We cond...

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Bibliographic Details
Published in:Infection 2014-12, Vol.42 (6), p.991-997
Main Authors: Leistner, R., Gürntke, S., Sakellariou, C., Denkel, L. A., Bloch, A., Gastmeier, P., Schwab, F.
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - pharmacology
Bacteremia - economics
Bacteremia - epidemiology
Bacteremia - microbiology
beta-Lactam Resistance
beta-Lactamases - biosynthesis
Cohort Studies
Cost of Illness
Cross Infection - economics
Cross Infection - microbiology
E coli
Escherichia coli - drug effects
Escherichia coli - enzymology
Escherichia coli Infections - economics
Escherichia coli Infections - epidemiology
Escherichia coli Infections - microbiology
Family Medicine
Female
General Practice
Germany - epidemiology
Humans
Infectious Diseases
Internal Medicine
Klebsiella Infections - economics
Klebsiella Infections - epidemiology
Klebsiella Infections - microbiology
Klebsiella pneumoniae - drug effects
Klebsiella pneumoniae - enzymology
Length of Stay
Male
Medicine
Medicine & Public Health
Middle Aged
Original Paper
Pathogens
Regression analysis
Retrospective Studies
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Summary:Purpose The burden of extended-spectrum beta-lactamase (ESBL)-positive Enterobacteriaceae (ESBL-E) is growing worldwide. We aimed to determine the financial disease burden attributable to ESBL-positive species in cases of bloodstream infection (BSI) due to K. pneumoniae and E. coli . Methods We conducted a cohort study on patients with BSI due to K. pneumoniae or E. coli between 2008 and 2011 in our institution. Data were collected on true hospital costs, length of stay (LOS), basic demographic parameters, underlying diseases as Charlson comorbidity index (CCI) and ESBL positivity of the pathogens. Multivariable regression analysis on hospital costs and length of stay was performed. Results Overall we found 1,851 consecutive cases of ESBL-E BSI, 352 (19.0 %) cases of K. pneumoniae BSI and 1,499 (81.0 %) cases of E. coli BSI. Sixty-six of E. coli BSI (18.8 %) and 178 of K. pneumoniae BSI (11.9 %) cases were due to ESBL-positive isolates, respectively ( p  = 0.001). 830 (44.8 %) cases were hospital-onset, 215 (61.1 %) of the K. pneumoniae and 615 (41.0 %) of the E. coli cases ( p  
ISSN:0300-8126
1439-0973
DOI:10.1007/s15010-014-0670-9