Risk factors in extenoeo-spectrum betalactamase producing Escherichia coli ano Klebsiella pneumoniae infection and colonization

Factores de riesgo en infección y colonización por Escherichia coli y Klebsiella pneumoniae productoras de betalactamasas de espectro extendido

Extended-spectrum betalactamases (ESBLs) are enzymes produced by gram-negative bacteria which are capable of destroying the betalactamic ring of third-generation cephalosporins enabling the bacteria to continue the peptido­ glican crosslinking process resulting in uilaltered integrity of the bacteria! cell wall. ESBLs were first detected in the 1980s. Its incidence increased and dissemination in all continents has lead to greater morbidity and mortality rates, prolonged hospitalization, greater usage of carbapenems and rising health care costs. Prediction of resistance patterns of infecting microorganisms based on the analysis of the risk factors associated facilitate optimal selection of empirical autibiotic treatment, rationalized use of available broad spectrum antibiotics and improvement of patient survival. This review searched for case studies and follow up trials which investigated the risk factors associated with ESBL producing bacterial infection or colonization, that is, previous exposure to antibiotics, hospitalization at the ICU, urinary catheterization, central venous catheterization and mechanical ventilation.

1. Villegas MV, Kallan JN, Quinteros MG, Casellas JM. Prevalence of extended­ spectrum beta-Iactamases in South America. Clin Microbio! lnfect. 2008;14 Suppl 1:154-8.
2. Schwaber MJ, Navon-Venezia S, Kaye KS, Ben-Ami R, Schwartz D, Carmeli Y. Clinical and economic impact of bacteremia with extended- spectrum-beta­ Iactamase-producing Enterobacteriaceae. Antimicrob Agents Chemother. 2006;50: 1257-62.
3. Paterson DL, Bonomo RA. Extended-spectrum beta-Iactamases: a clinical up­ date. Clin Microbio! Rev. 2005; 18:657-86.
4. Bush K, Jacoby GA. Updated functional classification of beta-lactamases. Anti­ microb Agents Chemother. 20 I 0;54:969-76.
5. Gunseren F, Marnikoglu L, Ozturk S, et al. A surveillance study of antimicrobial resistance of gram-negative bacteria isolated frorn intensive care units in eighl hospitals in Turkey. J Antimicrob Chemother. 1999;43:373-8.
6. Hanberger H, Garcia-Rodriguez JA, Gobernado M, Goossens H, Nilsson LE, Struelens MJ. Antibiotic susceptibility among aerobic gram-negative bacilli in intensive care units in 5 European countries. French and Portuguese !CU Study Groups. JAMA. 1999;281:67-71.
7. Albertini MT, Benoit C, Berardi L, et al. Surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae producing extended­ spectrurn beta-Iaclamase (ESBLE) in Northem France: a five-year multicentre incidence study. J Hosp Infect. 2002;52: 107-13.
8. Jacoby GA, Medeiros AA, O'Brien TF, Pinto ME, Jiang H. Broad-spectrum, transmissible beta-lactamases. N Engl J Med. I 988;319:723-4.
9. Moland ES, Black JA, Ourada J, Reisbig MD, Hanson ND, Thomson KS. Occu­ rrence of newer beta-lactamáses in Klebsiella pneumoniae isolates from 24 U.S. hospitals. Antimicrob Agents Chemother. 2002;46:3837-42.
10. National Nosocomial Infections Surveillance S. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 to June 2002, issued August 2002. Am J Infect Control. 2002;30:458-75.
11. Bell JM, Tumidge JD, Gales AC, Pfaller MA, Jones RN, Sentry ASG. Preva­ lence of extended spectrum beta-lactamase (ESBL)-producing clinical isolates in the Asia-Pacific region and South Africa: regional results from SENTRY Antimicrobial Surveillance Program (1998-99). Diagn Microbio! Infect Dis. 2002;42:193-8.
12. Lewis MT, Yamaguchi K, Biedenbach DJ, Jones RN. ln vitro evaluation of ce­ fepime and other broad-spectrum beta-lactams in 22 medica! centers in Japan: a phase II tria! comparing two annual organism samples. The Japan Antimicrobial Resistance Study Group. Diagn Microbio! lnfect Dis. 1999;35:307-15.
13. Yamaguchi K, Mathai D, Biedenbach DJ, Lewis MT, Gales AC, Jones RN. Evaluation of the in vitro activity of six broad-spectrum beta-lactam antimicro­ bial agents tested against over 2,000 clinical isolates from 22 medica] centers in Japan. Japan Antimicrobial Resistance Study Group. Diagn Microbio) Infect Dis. 1999;34:123-34.
14. Winokur PL, Canton R, Casellas JM, Legakis N. Variations in the prevalence of strains expressing an extended-spectrum beta-lactamase phenotype and charac­ terization of isolates from Europe, the Americas, and the Western Pacific region. Clin lnfect Dis. 2001;32 Suppl 2:S94-103.
15. Mendes C, Hsiung A, Kiffer C, et al. Evaluation of the in vitro activity of 9 antimicrobials against bacteria! strains isolated from patients in intensive care units in brazil: MYSTIC Antimicrobial Surveillance Program. Braz J lnfect Dis. 2000;4:236-44.
16. Miranda MC, Perez F, Zuluaga T, et al. [Antimicrobial resistance in gram nega­ tive bacteria isolated from intensive care units of Colombian hospitals, WHO­ NET 2003, 2004 and 2005]. Biomedica. 2006;26:424-33.
17. Otman J, Cavassin ED, Perugini ME, Vidotto MC. An outbreak of extended­ spectrum beta-lactamase-producing Klebsiella species in a neonatal intensive care unir in Brazil. lnfect Control Hosp Epidemiol. United States; 2002:8-9.
18. Pfaller MA, Jones RN, Doern GV. Multicenter evaluation of the antimicrobial activity for six broad-spectrum beta lactams in Venezuela: comparison of data from 1997 and 1998 using the Etest method. Venezuelan Antimicrobial Resis­ tance Study Group. Diagn Microbiol lnfect Dis.1999;35:153-8.
19. Sader HS, Jones RN, Gales AC, et al. Antimicrobial susceptibility patterns for pathogens isolated from patients in Latin American medica! centers with a diag­ nosis of pneurnonia: analysis of results from the SENTRY Antimicrobial Surveil­ lance Program (] 997). SENTRY Latin America Study Group. Diagn Microbio! Infect Dis. 1998;32:289-301.
20. Sader HS, Gales AC, Granacher TD, Pfaller MA, Jones RN, Group SS. Preva­ lence of antimicrobial resistance among respiratory tract isolates in Latin Amer­ ica: results from SENTRY antimicrobialsurveillance program (1997-98). Braz J Infect Dis. 2000;4:245-54.
21. Villegas MV, Correa A, Perez F, et al. Prevalence and characterization of ex­ tended-spectrum beta-lactamases in Klebsiella pneumoniae and Escherichia coli isolates from Colombian hospitals. Diagn Microbiol lnfect Dis. 2004;49:217-22.
22. Espinal P, Garza-Ramos U, Reyna F, et al. ldentification of SHV-type and CTX­ M-12 extended-spectrum beta-lactamases (ESBLs) in multiresistant Enterobac­ teriaceae from Colombian Caribbean hospitals. J Chemother. 2010;22:160-4.
23. Tumbarello M, Spanu T, Sanguinetti M, et al. llloodstream infections caused by extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae: risk factors, molecular epidemiology, and clinical outcome. Antimicrob Agents Che­ mother. 2006;50:498-504.
24. Superti SV, Augusti G, Zavascki AP. Risk factors for and mortality of exten­ ded-spectrum-beta-lactamase-producing Klebsiella pneumoniae and Escheri­ chia coli nosocornial bloodstream infections. Rev Inst Med Trop Sao Paulo. 2009;51:211-6.
25. Cordery RJ, Roberts CH, Cooper SJ, Bellinghan G, Shetty N. Evaluation of risk factors for the acquisition of bloodstream infections with extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella species in the in­tensive care unit; antibiotic management and clinical outcome. J Hosp lnfect. 2008;68:108-15.
26. Chenoweth CE, Saint S. Urinary tract infections. Infect Dis Clin North Am. 2011;25:103-15.
27. Saint S, Chenoweth CE. Biofilms and catheter-associated urinary tract infections. Infect Dis Clin North Am. 2003;17:411-32.
28. Warren JW, Darnron D, Tenney JH, Hoopes JM, Deforge B, Muncie HL, Jr. Fever, bacteremia, and death as complications of bacteriuria in women with long­ term urethral catheters. J Infect Dis. 1987;155:l 151-8.
29. Classen DC, Larsen RA, Burke JP, Stevens LE. Prevention of catheter associated bacteriuria: clinical tria] of methods to block three known pathways of infection. Am J lnfect Control. 1991;19:136-42.
30. Garibaldi RA, Burke JP, Britt MR, Miller MA, Smith CB. Meatal colonization and catheter-associated bacteriuria. N Engl J Med. l 980;303:316-8.
31. Hartstein Al, Garber SB, Ward TI, Jones SR, Morthland VH. Nosocomial uri­ nary tract infection: a prospective evaluation of 108 catheterized patients. Infect Control. 1981;2:380-6.
32. Kunin CM, McCormack RC. Prevention of catheter-induced urinary-tract infec­ tions by sterile closed drainage. N Engl J Med. 1966;274:1155-61.
33. Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary traer infection in adults: 2009 Internatio­ nal Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin lnfect Dis. 2010;50:625-63.
34. Maki DG, Tambyah PA. Engineering out the risk for infection with urinary catheters. Emerg lnfect Dis. 2001;7:342-7.
35. Huth TS, Burke JP, Larsen RA, Classen DC, Stevens LE. Randomized tria! of meatal care with silver sulfadiazine cream for the prevention of catheter-associa­ ted bacteriuria. J Infect Dis. 1992;165:14-8.
36. Platt R, Polk BF, Murdock B, Rosner B. Risk factors for nosocomial urinary tract infection. Arn J Epidemiol. 1986;124:977-85.
37. Anderson DJ, Kirkland KB, Kaye KS, et al. Underresourced hospital infection control and prevention programs: penny wise, pound foolish? Infect Control Hosp Epidemiol. 2007;28:767-73.
38. Jarvis WR. Selected aspects of the socioeconomic impact of nosocomial infec­ tions: morbidity, mortality, cost, and prevention. Infect Control Hosp Epidemiol. 1996;17:552-7.
39. Stone PW, Braccia D, Larson E. Systematic review of economic analyses of health care-associated infections. Am J Infect Control. 2005;33:501-9.
40. Edwards JR, Peterson KD, Andrus ML, et al. National Healthcare Safety Net­ work (NHSN) Report, data summary for 2006 through 2007, issued November 2008. Am J Infect Control. 2008;36:609-26.
41. Maki DG, Cobb L, Garman JK, Shapiro JM, Ringer M, Helgerson RB. An attachable silver-impregnated cuff for prevention of infection with cen_tral venous catheters: a prospective randomized multicenter trial. Am J Med. 1988:85:307-14.
42. Weber DJ, Rutala WA. Central line-associated bloodstream infections: preven­ tion and management. lnfect Dis Clin North Am. 2011;25:77-102.
43. Baker AM, Meredith JW, Haponik EF. Pneumonia in intubated trauma patients. Microbiology and outcomes. Am J Respir Crit Care Med. 1996;153:343-9.
44. Craig CP, Connelly S. Effect of intensive care unit nosocomial pneumonia on duration of stay and mortality. Am J Jnfect Control. 1984;12:233-8.
45. Cunnion KM, Weber DJ, Broadhead WE, Hanson LC, Pieper CF, Rutala WA. Risk factors for nosocomial pneumonia: comparing adult critical-care popula­ tions. Am J Respir Crit Care Med. 1996;153:158-62.
46. Jourdain B, Novara A, Joly-Guillou ML, et al. Role of quantitative cultures of endotracheal aspirates in the diagnosis of nosocomial pneumonia. Am J Respir Crit Care Med. 1995;152:241-6.
47. Warren DK, Shukla SJ, Olsen MA, et al. Outcome and attributable cost of ven­ tilator-associated pneumonia among intensive care unit patients in a suburban medica) center. Crit Care Med.2003;31:1312-7.
48. Boyce JM, Potter-Bynoe G, Dziobek L, Solomon SL. Nosocomial pneumónia in Medicare patients. Hospital costs and reimbursement pattems under the prospec­ tive payment system. Arcb Jntern Med. 1991;151:1109-14.
49. van Nieuwenhoven CA, Buskens E, Bergmans DC, van Tiel FH, Ramsay G, Bonten MJ. Oral decontamination is cost-saving in the prevention of ventilator­ associated pneumonia in intensive care units. Crit Care Med. 2004;32:126-30.
50. Cook DJ, Walter SO, Cook RJ, et al. lncidence of and risk factors far ventilator­ associated pneumonia in critically ill patients. Ann Intem Med. l998;129:433- 40.
51. Stonecypher K. Yentilator-associated pneumonia: the importance of oral care in intubated adults. Crit Care Nurs Q. 2010;33:339-47.
52. Cmich CJ, Safdar N, Maki DG. The role of the intensive care unit environment in the pathogenesis and prevention of ventilator-associated pneumonia. Respir Care. 2005;50:813-36; discussion 36-8.
53. O'Keefe-McCarthy S.Evidence-based nursing strategies to prevenl ventilator­ acquired pneumonia. Dynamics. 2006;17:8-l l.
54. Safdar N, Cmich CJ, Maki DG.The pathogenesis of ventilator-associaled pneu­ monia: its relevance to developing effective strategies far prevention. Respir Care. 2005;50:725-39; discussion 39-41.
55. Vincent JL, de Souza Barros D, Cianferoni S. Diagnosis, managemenl and pre­ vention of ventilator-associated pneumonia: an update. Drugs. 2010;70:1927-44.
56. Mendelson G, Hait V, Ben-Israel J, Gronich D, Granot E, Raz R. Prevalence and risk factors of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in an Israelí long-terrn care facility. Eur J Clin Microbio! Infecl Dis. 2005;24:17-22.
57. Wu Ul, Yang CS, Chen WC, Chen YC, Chang SC. Risk factors far bloodstream infections due to extended-spectrum belalactamase-producing Escherichia coli. J Microbio! Immunol Jnfect. 2010;43:310-6.
58. Rodríguez-Baño J, Pican E, Gijon P, et al.Community-onset bacteremia due to extended-spectrum beta lactamase-producing Escherichia coli: risk factors and prognosis. Clin lnfect Dis. 2010;50:40-8.
59. Rodríguez-Baño J, Pican E, Gijon P, el al. Risk factors and prognosis of noso­ comial bloodstream infections caused by extended-spectrum-beta-lactamase­ producing Escherichia coli. J Clin Microbio). 2010;48:1726-31.
60. Rodríguez-Baño J, Navarro MD, Romero L, et al. Risk-factors far emerging bloodstream infeclions caused by extended-spectrum beta-lactamase-producing Escherichia coli. Clin Microbio) Infect. 2008;14:180-3.
61. Chaiwarith R, Pasogpakdee P, Salee P, Kanjanaratanakorn K, Sirisanthana T, Supparatpinyo K. Risk factors far extended-spectrum beta lactamase-producing Klebsiella pneumoniae and Escherichia coli acquisition in a te11iary care teaching hospital in Thailand. J Hosp lnfect. England. 2009:285-6.
62. Lin MF, Huang ML, Lai SH. Risk factors in the acquisition of extended-spectrum beta-lactamase Klebsiella pneumoniae: a case-control study in a district teaching hospital in Taiwan.J Hosp lnfect. 2003;53:39-45.
63. Kuster SP, Hasse B, Huebner V, et al.Risks factors far infections with extended­ spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae at a tertiary care universityhospital in Switzerland. lnfection. 2010;38:33-40.
64. Kang CI, Song JH, Chung DR, et al. Risk factors and treatment outcomes of community-onset bacteraemia caused by extended-spectrum beta-lactamase­ producing Escherichia coli. lnt J Antimicrob Agents. 2010;36:284-7.
65. Kang CI, Chung DR, Ko KS, Peck KR, Song JH, Korean Network far Study of Infectious D. Risk factors for infection and treatment outcome of exten­ ded-spectrum beta-lactamase-producing Eschericbia coli and Klebsiella pneu­ moniae bacteremia in patients with hematologic malignancy. Ann Hematol. 2012;91:I 15-21.
66. Hyle EP, Lipworth AD, Zaoutis TE, et al. Risk factors far increasing multidrug resistance among extended-spectrumbeta-lactamase-producing Escherichia coli and Klebsiella species. Clin lnfect Dis. 2005;40:1317-24.
67. Quirante OFn, Cerralo SG, Pardos SL. Risk factors for bloodstream infeclions caused by extended-spectrum 2-lactamase-producing Escherichia coli and Kleb­ siella pneumoniae. Braz J lnfect Dis. 2011 Jul-Aug;l5{4):370-6.
68. Ho PL, Chan WM, Tsang KW, Wong SS, Young K. Bacteremia caused by Es­ cherichia coli producing exlended-spectrum beta-lactamase: a case-control study of risk factors and outcomes. Scand J lnfect Dis. 2002;34:567-73.
69. Peña C, Gudiol C, Tubau F, et al. Risk-factors far acquisition of extended-spec­ trum beta-lactamase-producing Escherichia coli among hospitalised patients. Clin Microbiol lnfect. 2006;12:279-84.
70. García Hemandez A, García-Yazquez E, Gomez Gomez J, Canteras M, Her­ nandez-Torres A, Ruiz Gomez J. [Prediclive factors of ESBL versus non-ESBL Escherichia coli bacteraemia and influence of resistance on the mortality of the patients]. Med Clin (Barc). 2011;136:56-60.
71. Harris AD, McGregor JC, Johnson JA, et al. Risk faclors far colonization with extended-spectrum beta-lactarnase-producing bacteria and intensive care unit ad­ mission. Emerg lnfect Dis. 2007;13:1144-9.
72. Du B, Long Y. Liu H, el al. Extended-spectrum beta-lactamase-producing Es­ cherichia coli and Klebsiella pneumoniae bloodstream infection: risk factors and clinical outcome. Intensive Care Med.2002;28:1718-23.
73. Wener KM, Schechner V, Gold HS, Wrighl SB, Carmeli Y. Trealment with fluoroquinolones or with beta-lactam-beta-laclamase inhibitor combinations is a risk factor far isolation of extended-spectrum-beta-lactamase-producing Klebsiella species in hospitalized patients. Antimicrob Agents Chemother. 2010;54:2010-6.
74. Velasco Arribas M, Barrena Puerta R, Asenjo Mota A, Yalverde Canovas JF, Delgado-lribarren A, Losa García JE. [Risk factors for extended espectrum bela­ lactamase producer E.coli bacteremia from urinary origin]. Med Clin (Barc). 2010;134:392-5.