Risk factors in the acquisition of extended-spectrum β-lactamase Klebsiella pneumoniae: a case–control study in a district teaching hospital in Taiwan

A case–control study was performed to find the risk factors in the acquisition of extended-spectrum β-lactamase (ESBL) Klebsiella pneumoniae. From 1 May 2001 to 30 September 2001, 422 isolates ofK. pneumoniae identified by the microbiological laboratory in Hsin-Chu hospital were collected, 59 of whi...

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Bibliographic Details
Published in:The Journal of hospital infection 2003-01, Vol.53 (1), p.39-45
Main Authors: Lin, M.-F., Huang, M.-L., Lai, S.-H.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Biological and medical sciences
Case-Control Studies
Catheterization - adverse effects
Ceftazidime - pharmacology
Cephalosporin Resistance
Female
Hospitalization
Hospitals, District
Hospitals, Teaching
Humans
Infectious diseases
K. pneumoniae, ESBLs, risk factors, ceftazidime
Klebsiella Infections - epidemiology
Klebsiella Infections - microbiology
Klebsiella pneumoniae - isolation & purification
Klebsiella pneumoniae - physiology
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Prevalence
Risk Factors
Taiwan - epidemiology
Tracheostomy - adverse effects
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Summary:A case–control study was performed to find the risk factors in the acquisition of extended-spectrum β-lactamase (ESBL) Klebsiella pneumoniae. From 1 May 2001 to 30 September 2001, 422 isolates ofK. pneumoniae identified by the microbiological laboratory in Hsin-Chu hospital were collected, 59 of which were ESBL-producing strains. The prevalence rate was 14% (59/422). There were 43 case patients (ESBL-producing K. pneumoniae) and 86 controls (non-ESBL-producing K. pneumoniae). Tracheostomy, insertion of a Foley catheter, endotracheal tube, nasogastric tube and central venous catheter were found to be risk factors in the acquisition of K. pneumoniae with ESBLs by univariate analysis. Tracheostomy (odds ratio, 5.13; 95% CI, 1.24–21.1;P =0.023) and ceftazidime use (odds ratio, 13.40; 95% CI, 1.21–148.85; P=0.035) remained as risk factors by multivariate analysis with logistic regression. Other anti-pseudomonal agents should be used as empirical therapy to treat possible Pseudomonas aeruginosa infection in order to reduce ceftazidime use and thereby decrease the prevalence of ESBL producing strains of Enterobacteriaceae.
ISSN:0195-6701
1532-2939
DOI:10.1053/jhin.2002.1331