Journal
CRITICAL REVIEWS IN MICROBIOLOGY
Volume 42, Issue 1, Pages 1-16Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/1040841X.2013.875515
Keywords
Bloodstream infection; colonization; ESBL; ICU; malignancy; neutropenia
Categories
Funding
- German Federal Ministry of Research and Education (BMBF) [01KN1106]
- 3M
- Actelion
- Astellas
- Basilea
- Bayer
- Celgene
- Cubist
- F2G
- Genzyme
- Gilead
- GSK
- Merck/MSD
- Miltenyi
- Optimer
- Pfizer
- Quintiles
- Sanofi Pasteur
- Viropharma
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Background: The prevalence of extended-spectrum -lactamase producing Enterobacteriaceae (ESBL-E) is increasing worldwide. ESBL-E are known to colonize different body sites and cause bloodstream infections (BSI), pneumonia, intra-abdominal infections and urinary tract infections. Even though ESBL-E-related morbidity and mortality in high-risk patients - patients receiving immunosuppressants or chemotherapy, as well as those treated in an ICU - is considerable, the management of ESBL-E in these populations has not been systematically reviewed. Methods: For the purpose of this review, ICU patients, patients in hematology and oncology wards and transplant recipients were considered high-risk. An English-language Medline search was conducted to identify literature on epidemiology, risk factors, clinical impact and measures of infection control regarding ESBL-E in high-risk patients published between June 2002 and May 2013. Results: Using the above described methodology, 43 relevant articles regarding high-risk patients and - for areas where literature on exclusively high-risk patients is scarce - 17 articles in standard risk settings were identified. The evidence on epidemiology, associated risk factors, treatment and hygiene measures were summarized. Discussion: This review gives a complete overview on the management of ESBL-E in the high-risk setting.
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