Molecular Correlation for the Treatment Outcomes in Bloodstream Infections Caused by Escherichia coli and Klebsiella pneumoniae with Reduced Susceptibility to Ceftazidime

Data are limited on outcomes of treatment with extended-spectrum cephalosporins (ESCs) for infections caused by Enterobacteriaceae that produce extended-spectrum β-lactamases (ESBLs). This study describes the largest treatment experience of a nonoutbreak series of bloodstream infections caused by st...

Full description

Saved in:
Bibliographic Details
Published in:Clinical infectious diseases 2002-01, Vol.34 (2), p.135-146
Main Authors: Wong-Beringer, Annie, Hindler, Janet, Loeloff, Michael, Queenan, Anne Marie, Lee, Nancy, Pegues, David A., Quinn, John P., Bush, Karen
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Data are limited on outcomes of treatment with extended-spectrum cephalosporins (ESCs) for infections caused by Enterobacteriaceae that produce extended-spectrum β-lactamases (ESBLs). This study describes the largest treatment experience of a nonoutbreak series of bloodstream infections caused by strains of Escherichia coli (23 episodes) and Klebsiella pneumoniae (13 episodes) with a ceftazidime minimal inhibitory concentration of ⩾2 µg/mL. E. coli isolates produced a greater variety of β-lactamase types than did K. pneumoniae isolates, among which ESBL production was predominant. Five ESBL types were identified: TEM-12, TEM-71, TEM-6, SHV-12, and SHV-5. Most patients were treated empirically with an ESC-based regimen. A favorable response to treatment with a nonceftazidime ESC was observed when the causative pathogen produced either TEM-6 or TEM-12; ceftazidime treatment was associated with failure of therapy in all patients. Despite the limited clinical success, ESCs are currently not recommended for the treatment of serious infections caused by ESBL-producing strains.
ISSN:1058-4838
1537-6591
DOI:10.1086/324742