| Title |
Frequency, associated factors and outcome of multi-drug-resistant intensive care unit-acquired pneumonia among patients colonized with extended-spectrum β-lactamase-producing Enterobacteriaceae
|
|---|---|
| Published in |
Annals of Intensive Care, June 2017
|
| DOI | 10.1186/s13613-017-0283-4 |
| Pubmed ID | |
| Authors |
Keyvan Razazi, Armand Mekontso Dessap, Guillaume Carteaux, Chloé Jansen, Jean-Winoc Decousser, Nicolas de Prost, Christian Brun-Buisson |
| Abstract |
We assessed prevalence, associated factors and prognosis of extended-spectrum beta-lactamase-producing Enterobacteriaceae pneumonia acquired in intensive care unit (ESBL-PE pneumonia) among carriers. Variables associated with nosocomial pneumonia caused by carbapenem-resistant bacteria (CRB) were also assessed. A 6-year prospective study (May 2009-March 2015) in the medical ICU of an 850-bed university-affiliated hospital was conducted. Of the 6303 patients admitted, 843 (13.4%) had ESBL-PE carriage detected. Among carriers, 111 (13%) patients developed ICU-acquired pneumonia of whom 48 (43%) had ESBL-PE pneumonia (6% of carriers). By multivariable analysis, SAPS II at admission >43 [OR 2.81 (1.16-6.79)] and colonization with Enterobacter sp. or K. pneumoniae species [OR 10.96 (2.93-41.0)] were independent predictive factors for ESBL-PE pneumonia in colonized patients, whereas receipt of >2 days of amoxicillin/clavulanic acid during the ICU stay [OR 0.24 (0.08-0.71)] was protective. Patients with ESBL-PE pneumonia had a higher SOFA score (p = 0.037) and more frequent septic shock at pneumonia onset (p = 0.047). However, ESBL-PE pneumonia was not an independent predictor of mortality. Twenty-five patients had pneumonia caused by CRB. Chronic renal insufficiency, administration of third-generation cephalosporin within the past 3 months, acute respiratory distress syndrome before pneumonia and prior therapy with a carbapenem or fluoroquinolones were associated with CRB pneumonia in this selected population. Although few ESBL-PE carriers developed ESBL-PE pneumonia overall, a high proportion of pneumonia were caused by ESBL-PE in carriers developing ICUAP. ESBL-PE pneumonia was not an independent predictor of mortality. As pneumonia caused by CRB is increasing, knowledge of factors associated with ESBL-PE or CRB pneumonia may help empiric therapy of pneumonia among ESBL-PE carriers. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 84 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 84 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 13 | 15% |
| Researcher | 11 | 13% |
| Student > Bachelor | 7 | 8% |
| Other | 6 | 7% |
| Student > Ph. D. Student | 5 | 6% |
| Other | 12 | 14% |
| Unknown | 30 | 36% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 26% |
| Immunology and Microbiology | 8 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 6% |
| Engineering | 3 | 4% |
| Nursing and Health Professions | 2 | 2% |
| Other | 10 | 12% |
| Unknown | 34 | 40% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 July 2017.
All research outputs
#18,555,330
of 22,981,247 outputs
Outputs from Annals of Intensive Care
#921
of 1,051 outputs
Outputs of similar age
#242,034
of 317,411 outputs
Outputs of similar age from Annals of Intensive Care
#22
of 29 outputs
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