Escherichia coli producing SHV-type extended-spectrum beta-lactamase is a significant cause of community-acquired infection
Por:
Rodriguez-Bano, J, Alcala, J, Cisneros, JM, Grill, F, Oliver, A, Horcajada, JP, Tortola, T, Mirelis, B, Navarro, G, Cuenca, M, Esteve, M, Pena, C, Llanos, AC, Canton, R, Pascual, A
Publicada:
1 abr 2009
Resumen:
Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is an increasingly significant cause of community-acquired infection worldwide. The epidemiological features of CTX-M- and SHV-producing ESBLEC causing community-acquired infections are compared.
A multicentre cohort study including all community-acquired infections caused by ESBLEC in four geographical areas of Spain was carried out. ESBL characterization was by isoelectric focusing, PCR and sequencing. Demographics, previous healthcare contact, co-morbidity, use of antimicrobials, invasive procedures and type of infection were collected for all patients. Patients with CTX-M- and SHV-producing isolates were compared using logistic regression.
One hundred and twenty-two cases (95% urinary tract infections) were included. ESBLs were characterized in 112 isolates; 77 isolates (69%) produced CTX-M, 36 (32%) produced SHV and 7 (6%) produced TEM enzymes (8 produced > 1 ESBL). Patients with isolates producing CTX-M enzymes only (CTX-M group, n = 70) and SHV enzymes only (SHV group, n = 31) were compared. There were no differences in terms of underlying disease, previous healthcare contact, invasive procedures, antibiotic use or type of infection. Multivariate analysis including geographical area showed that a Charlson Index score of > 2 (OR = 4.0; 95% CI = 1.2-12.6) was associated with SHV isolates, while age > 60 (4.7; 1.7-12.5) was associated with CTX-M isolates.
SHV-producing ESBLEC is a significant cause of community-acquired infection in Spain; the clinical epidemiology of such isolates seems very similar to that of CTX-M-producing E. coli.
Filiaciones:
Rodriguez-Bano, J:
Hosp Univ Virgen Macarena, Secc Enfermedades Infecciosas, Seville, Spain
Alcala, J:
Hosp Univ Virgen Macarena, Microbiol Serv, Seville, Spain
Cisneros, JM:
Hosp Univ Virgen Rocio, Serv Enfermedades Infecciosas, Seville, Spain
Grill, F:
Hosp Univ Ramon & Cajal, Serv Enfermedades Infecciosas, Madrid, Spain
Oliver, A:
Hosp Son Dureta, Microbiol Serv, Palma de Mallorca, Spain
Horcajada, JP:
Hosp Clin Barcelona, Serv Enfermedades Infecciosas, Barcelona, Spain
Tortola, T:
Hosp Valle dHebron, Microbiol Serv, Barcelona, Spain
Mirelis, B:
Hosp Santa Cruz & St Pau, Microbiol Serv, Barcelona, Spain
Navarro, G:
Corp Sanitaria Parc Tauli, Unidad Epidemiol, Sabadell, Spain
Cuenca, M:
Hosp Ribera, Microbiol Serv, Valencia, Spain
Esteve, M:
Hosp Univ Germans Trias & Pujol, Unidad Med Prevent, Badalona, Spain
Pena, C:
Hosp Univ Bellvitge, Serv Enfermedades Infecciosas, Barcelona, Spain
Llanos, AC:
Hosp Univ Virgen Rocio, Serv Enfermedades Infecciosas, Seville, Spain
Canton, R:
Hosp Ramon & Cajal, Microbiol Serv, E-28034 Madrid, Spain
Pascual, A:
Hosp Univ Virgen Macarena, Microbiol Serv, Seville, Spain
Fac Med, Dept Microbiol, Seville, Spain
Hosp Clin Barcelona, Servicio Enfermedades Infecciosas, Barcelona, Spain.
Bronze
|