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A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients.

dc.rights.licenseopenen_US
dc.contributor.authorBEN-AMI, Ronen
dc.contributor.authorRODRÍGUEZ-BAÑO, Jesús
dc.contributor.authorARSLAN, Hande
dc.contributor.authorPITOUT, Johann D D
hal.structure.identifierMicrobiologie Fondamentale et Pathogénicité [MFP]
dc.contributor.authorQUENTIN, Claudine
dc.contributor.authorCALBO, Esther S
dc.contributor.authorAZAP, Ozlem K
hal.structure.identifierMicrobiologie Fondamentale et Pathogénicité [MFP]
dc.contributor.authorARPIN, Corinne
IDREF: 093324626
dc.contributor.authorPASCUAL, Alvaro
dc.contributor.authorLIVERMORE, David M
dc.contributor.authorGARAU, Javier
dc.contributor.authorCARMELI, Yehuda
dc.date.accessioned2024-10-30T14:36:02Z
dc.date.available2024-10-30T14:36:02Z
dc.date.issued2009-09-01
dc.identifier.issn1537-6591en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/203001
dc.description.abstractEnInfections caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are increasing in frequency and are associated with high mortality rates. Circulation of CTX-M-type ESBLs in the community is of particular concern, because it may confound standard infection-control measures. We analyzed the results of epidemiologic studies of infection caused by ESBL-producing Enterobacteriaceae in nonhospitalized patients from 6 centers in Europe, Asia, and North America. Risk factors for infection with an ESBL-producing organism were identified by univariate and multivariate analyses. A total of 983 patient-specific isolates were reviewed (890 [90.5%] of which were Escherichia coli, 68 [6.9%] of which were Klebsiella species, and 25 [2.5%] of which were Proteus mirabilis); 339 [34.5%] of the isolates produced ESBLs. CTX-M types were the most frequent ESBLs (accounting for 65%). Rates of co-resistance to ciprofloxacin among ESBL-producing isolates were high (>70%), but significant variation was seen among centers with respect to rates of resistance to gentamicin, amoxicillin-clavulanate, and trimethoprim-sulfamethoxazole. Similar risk factors for infection with an ESBL-producing organism were found in the different participating centers. Significant risk factors, identified by multivariate analysis, were recent antibiotic use, residence in a long-term care facility, recent hospitalization, age 65 years, and male sex (area under the receiver-operator characteristic [ROC] curve, 0.80). However, 34% of ESBL-producing isolates (115 of 336 isolates) were obtained from patients with no recent health care contact; the area under the ROC curve for the multivariate model for this group of patients was only 0.70, which indicated poorer predictive value. Community-acquired ESBL-producing Enterobacteriaceae are now prevalent worldwide, necessitating international collaboration. Novel approaches are required to adequately address issues such as empirical treatment for severe community-acquired infection and infection control.
dc.language.isoENen_US
dc.subject.enCommunity-Acquired Infections
dc.subject.enEnterobacteriaceae
dc.subject.enEnterobacteriaceae Infections
dc.subject.enFemale
dc.subject.enGlobal Health
dc.subject.enHealth Surveys
dc.subject.enHumans
dc.subject.enMale
dc.subject.enMicrobial Sensitivity Tests
dc.subject.enMultivariate Analysis
dc.subject.enPrevalence
dc.subject.enROC Curve
dc.subject.enRisk Factors
dc.subject.enbeta-Lactam Resistance
dc.subject.enbeta-Lactamases
dc.title.enA multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients.
dc.title.alternativeClin Infect Disen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1086/604713en_US
dc.subject.halSciences du Vivant [q-bio]/Microbiologie et Parasitologieen_US
dc.identifier.pubmed19622043en_US
bordeaux.journalClinical Infectious Diseasesen_US
bordeaux.page682-90en_US
bordeaux.volume49en_US
bordeaux.hal.laboratoriesMFP (Laboratoire Microbiologie Fondamentale et Pathogénicité) - UMR 5234en_US
bordeaux.issue5en_US
bordeaux.institutionCNRSen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcepubmed
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcepubmed
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Clinical%20Infectious%20Diseases&rft.date=2009-09-01&rft.volume=49&rft.issue=5&rft.spage=682-90&rft.epage=682-90&rft.eissn=1537-6591&rft.issn=1537-6591&rft.au=BEN-AMI,%20Ronen&RODR%C3%8DGUEZ-BA%C3%91O,%20Jes%C3%BAs&ARSLAN,%20Hande&PITOUT,%20Johann%20D%20D&QUENTIN,%20Claudine&rft.genre=article


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