Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia
- Autori: Villafuerte D.; Aliberti S.; Soni N.J.; Faverio P.; Marcos P.J.; Wunderink R.G.; Rodriguez A.; Sibila O.; Sanz F.; Martin-Loeches I.; Menzella F.; Reyes L.F.; Jankovic M.; Spielmanns M.; Restrepo M.I.; Aruj P.K.; Attorri S.; Barimboim E.; Caeiro J.P.; Garzon M.I.; Cambursano V.H.; Ceccato A.; Chertcoff J.; Cordon Diaz A.; de Vedia L.; Ganaha M.C.; Lambert S.; Lopardo G.; Luna C.M.; Malberti A.G.; Morcillo N.; Tartara S.; Pensotti C.; Pereyra B.; Scapellato P.G.; Stagnaro J.P.; Shah S.; Lotsch F.; Thalhammer F.; Anseeuw K.; Francois C.A.; Van Braeckel E.; Vincent J.L.; Djimon M.Z.; Nouer S.A.; Chipev P.; Encheva M.; Miteva D.; Petkova D.; Balkissou A.D.; Yone E.W.P.; Ngahane B.H.M.; Shen N.; Xu J.-F.; Rico C.A.B.; Buitrago R.; Paternina F.J.P.; Ntumba J.-M.K.; Carevic V.V.; Jakopovic M.; Jankovic M.; Matkovic Z.; Mitrecic I.; Jacobsson M.-L.B.; Christensen A.B.; Heitmann Bodtger U.C.; Meyer C.N.; Jensen A.V.; El-Said Abd El-Wahhab I.; Morsy N.E.; Shafiek H.; Sobh E.; Abdulsemed K.A.; Bertrand F.; Brun-Buisson C.; Montmollin E.D.; Fartoukh M.; Messika J.; Tattevin P.; Khoury A.; Ebruke B.; Dreher M.; Kolditz M.; Meisinger M.; Pletz M.W.; Hagel S.; Rupp J.; Schaberg T.; Spielmanns M.; Creutz P.; Suttorp N.; Siaw-Lartey B.; Dimakou K.; Papapetrou D.; Tsigou E.; Ampazis D.; Kaimakamis E.; Bhatia M.; Dhar R.; D'Souza G.; Garg R.; Koul P.A.; Mahesh P.A.; Jayaraj B.S.; Narayan K.V.; Udnur H.B.; Krishnamurthy S.B.; Kant S.; Swarnakar R.; Limaye S.; Salvi S.; Golshani K.; Keatings V.M.; Martin-Loeches I.; Maor Y.; Strahilevitz J.; Battaglia S.; Carrabba M.; Ceriana P.; Confalonieri M.; Monforte A.D.; Prato B.D.; Rosa M.D.; Fantini R.; Fiorentino G.; Gammino M.A.; Menzella F.; Milani G.; Nava S.; Palmiero G.; Petrino R.; Gabrielli B.; Rossi P.; Sorino C.; Steinhilber G.; Zanforlin A.; Franzetti F.; Carone M.; Patella V.; Scarlata S.; Comel A.; Kurahashi K.; Bacha Z.A.; Ugalde D.B.; Zuniga O.C.; Villegas J.F.; Medenica M.; van de Garde E.M.W.; Mihsra D.R.; Shrestha P.; Ridgeon E.; Awokola B.I.; Nwankwo O.N.O.; Olufunlola A.B.; Olumide S.; Ukwaja K.N.; Irfan M.; Minarowski L.; Szymon S.; Froes F.; Leuschner P.; Meireles M.; Ravara S.B.; Brocovschii V.; Ion C.; Rusu D.; Toma C.; Chirita D.; Dorobat C.M.; Birkun A.; Kaluzhenina A.; Almotairi A.; Bukhary Z.A.A.; Edathodu J.; Fathy A.; Enani A.M.A.; Mohamed N.E.; Memon J.U.; Bella A.; Bogdanovic N.; Milenkovic B.; Pesut D.; Borderias L.; Garcia N.M.B.; Cabello Alarcon H.; Cilloniz C.; Torres A.; Diaz-Brito V.; Casas X.; Gonzalez A.E.; Fernandez-Almira M.L.; Gallego M.; Gaspar-Garcia I.; Castillo J.G.D.; Victoria P.J.; Laserna Martinez E.; Molina R.M.D.; Marcos P.J.; Menendez R.; Pando-Sandoval A.; Aymerich C.P.; Rello J.; Moyano S.; Sanz F.; Sibila O.; Rodrigo-Troyano A.; Sole-Violan J.; Uranga A.; van Boven J.F.M.; Torra E.V.; Pujol J.A.; Feldman C.; Yum H.K.; Fiogbe A.A.; Yangui F.; Bilaceroglu S.; Dalar L.; Yilmaz U.; Bogomolov A.; Elahi N.; Dhasmana D.J.; Feneley A.; Hancock C.; Hill A.T.; Rudran B.; Ruiz-Buitrago S.; Campbell M.; Whitaker P.; Youzguin A.; Singanayagam A.; Allen K.S.; Brito V.; Dietz J.; Dysart C.E.; Kellie S.M.; Franco-Sadud R.A.; Meier G.; Gaga M.; Holland T.L.; Bergin S.P.; Kheir F.; Landmeier M.; Lois M.; Nair G.B.; Patel H.; Reyes K.; Rodriguez-Cintron W.; Saito S.; Soni N.J.; Noda J.; Hinojosa C.I.; Levine S.M.; Angel L.F.; Anzueto A.; Whitlow K.S.; Hipskind J.; Sukhija K.; Totten V.; Wunderink R.G.; Shah R.D.; Mateyo K.J.; Noriega L.; Alvarado E.; Aman M.; Labra L.
- Anno di pubblicazione: 2019
- Tipologia: Articolo in rivista
- Parole Chiave: community-acquired pneumonia; Enterobacteriaceae; multidrug-resistance; prevalence; risk factors
- OA Link: http://hdl.handle.net/10447/401978
Abstract
Background and objective: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.