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Risks Factors for Infections with Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae at a Tertiary Care University Hospital in Switzerland

  • Clinical and Epidemiological Study
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Abstract

Background:

There are considerable geographical differencesin the occurrence of extended-spectrum beta-lactamase(ESBL)-producing bacteria, both in the community and in thehospital setting. Our aim was to assess risk factors forbloodstream, urinary tract, and vascular catheter-associatedinfections with ESBL-producing Escherichia coli and Klebsiellapneumoniae at a tertiary care hospital in a low-prevalencecountry.

Methods:

We performed a case-control study comparing 58patients with infections due to ESBL-producing E. coli orK. pneumoniae vs 116 controls with infections due to non-ESBL producing organisms at the University Hospital Zurich,Switzerland, between 1 July 2005 and 30 June 2007.

Results:

Cases included 15 outpatients and 43 inpatients.Multivariable analyses found three risk factors for ESBL-producingisolates: begin of symptoms or recent antibioticpre-treatment in a foreign country (odds ratio [OR] 27.01,95% confidence interval [CI] 2.38–1,733.28], p = 0.042),antibiotic therapy within the year preceding the isolation ofthe ESBL-producing strain (OR 2.88, 95% CI 1.13–8.49,p = 0.025), and mechanical ventilation (OR 10.56, 95% CI1.06–579.10, p = 0.042).

Conclusions:

The major risk factors for infections due toESBL-producing bacteria were travel in high-prevalencecountries, prior antibiotic use, and mechanical ventilationduring a stay in the intensive care unit. Community-acquiredinfections were documented in 17% of the patients.An early identification of risk factors is crucial to providingthe patients an optimal empiric antibiotic therapy and tokeep the use of carbapenems to a minimum.

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Authors and Affiliations

  1. Division of Infectious Diseases and Hospital Epidemiology, UniversityHospital Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    S. P. Kuster, B. Hasse, V. Huebner, V. Bansal, C. Ruef, B. Ledergerber & R. Weber

  2. Institute of Medical Microbiology, University of Zurich, Gloriastrasse30/32, 8006, Zurich, Switzerland

    R. Zbinden

Authors
  1. S. P. Kuster
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  2. B. Hasse
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  3. V. Huebner
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  4. V. Bansal
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  5. R. Zbinden
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  6. C. Ruef
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  7. B. Ledergerber
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Corresponding author

Correspondence to B. Hasse.

Additional information

S.P. Kuster, B. Hasse, and V. Huebner contributed equally to this work.

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Kuster, S.P., Hasse, B., Huebner, V. et al. Risks Factors for Infections with Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae at a Tertiary Care University Hospital in Switzerland. Infection 38, 33–40 (2010). https://doi.org/10.1007/s15010-009-9207-z

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  • DOI: https://doi.org/10.1007/s15010-009-9207-z

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