Journal
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE
Volume 94, Issue 3, Pages 287-292Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.diagmicrobio.2019.01.018
Keywords
Bacteremia; Extended-spectrum beta-lactamase; Febrile neutropenia; Piperacillin/tazobactam; Sepsis
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Funding
- Research Program on Emerging and Re-emerging Infectious Diseases from the Japan Agency Development, AMED [JP 17fk0108208, 18fk0108052h0002]
- JSPS KAKENHI [16K09939]
- Grants-in-Aid for Scientific Research [16K09939] Funding Source: KAKEN
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This study aimed to assess the prognostic factors of patients with bacteremia due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) as well as the antimicrobial susceptibility, particularly to piperacillin/tazobactam (PTZ), among ESBL-PE strains. The medical records of 65 patients with ESBL-PE bacteremia divided into the survivor group (n = 52) and nonsurvivor group (n = 13) were retrospectively reviewed. The male-to-female ratio, age, underlying disease, leukocyte count, C-reactive protein level, and treatment did not differ between the 2 groups. Multivariate analysis showed that the independent predictors associated with hospital mortality of ESBL-PE bacteremia were sepsis (P = 0.047) and febrile neutropenia (P = 0.008); thus, early assessment of these conditions is important. Further, the minimum inhibitory concentration values of ESBL-PE isolates in nonsurvivors tended to be higher than those in survivors. PTZ should be used with caution in cases of ESBL-PE strains with low susceptibility to the drug. (C) 2019 Elsevier Inc. All rights reserved.
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