Vance Mary Kathryn, Cretella David A, Ward Lori M, Vijayvargiya Prakhar, Garrigos Zerelda Esquer, Wingler Mary Joyce B
Department of Pharmacy, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Department of Antimicrobial Stewardship, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Pharmacy (Basel). 2023 Apr 13;11(2):74. doi: 10.3390/pharmacy11020074.
(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January 2019 to July 2021 and had positive blood cultures for , , , and . Patients with ESBL infection were matched to a non-ESBL-producing infection with the same organism. (3) Results: A total of 150 patients were included: 50 in the ESBL group and 100 in the non-ESBL group. Patients in the ESBL group had a longer length of stay (11 vs. 7 days, < 0.001), but not increased mortality (14% vs. 15%, = 0.87) Multivariate analysis identified the receipt of >1 antibiotic in the last 90 days as a risk factor for ESBL infection (OR = 3.448, 95% CI = 1.494-7.957; = 0.004); (4) Conclusions: Recent antimicrobial use was identified as an independent risk factors for ESBL-producing Enterobacterales infections. Knowledge of this risk may improve empirical therapy and reduce inappropriate use.
(1) 背景：超广谱β-内酰胺酶（ESBL）感染的危险因素可能因地域而异。本研究的目的是确定革兰氏阴性菌血症患者产生ESBL的局部危险因素。(2) 方法：这项回顾性观察性研究纳入了2019年1月至2021年7月入院且血培养结果为 、 、 及 的成年患者。ESBL感染患者与相同病原体的非产ESBL感染患者进行匹配。(3) 结果：共纳入150例患者：ESBL组50例，非ESBL组100例。ESBL组患者住院时间更长（11天对7天， <0.001），但死亡率未增加（14%对15%， =0.87）。多因素分析确定在过去90天内接受>1种抗生素治疗是ESBL感染的危险因素（OR=3.448，95%CI=1.494 - 7.957； =0.004）；(4) 结论：近期使用抗菌药物被确定为产ESBL肠杆菌科细菌感染的独立危险因素。了解这一风险可能会改善经验性治疗并减少不当使用。
