Clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia and their emergence in the community

Jen-Chieh Lee, Nan-Yao Lee, Hsin Chun Lee, Wei Han Huang, Ko Chung Tsui, Chia-Ming Chang, Ching Chi Lee, Po-Lin Chen, Chi Jung Wu, Po Ren Hsueh, Wen-Chien Ko

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: The purpose of this study is to delineate clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) in different clinical settings, with an emphasis on community-acquired infections. Methods: A retrospective study was conducted at two medical centers in Taiwan. From May 2002 to August 2007, clinical data of adults with urosepsis caused by ESBL-EK were collected. Patients were categorized into three groups according to the place of acquisition. Baseline characteristics, microbiological data and clinical outcomes were compared. Results: Ninety-three cases of ESBL-EK urosepsis were included. Their mean age was 69.4 years, and 48.4% were men. Eleven (11.8%), 41 (44.1%), and 41 (44.1%) patients were categorized as having community-acquired, healthcare-associated, and hospital-acquired infections, respectively. Cases of ESBL-EK urosepsis from different settings shared similar characteristics in terms of age, gender, comorbidity and resistance profiles of bacterial strains. Of the bacterial isolates, 75% and 38.7% were resistant to fluoroquinolones and aminoglycosides, respectively. Cases of community-acquired urosepsis had a lower disease severity than those acquired in healthcare facilities or hospitals. Of note, there was no case fatality in 11 cases of community-acquired urosepsis and, in contrast, a crude mortality rate of 41.5% was found among adults with hospital-acquired urosepsis (p < 0.001). Conclusion: A limited number of adults with community-acquired urosepsis caused by ESBL-EK in the present study had a favorable outcome. Nonetheless, clinicians should be cautious of the emergence of urinary tract infections caused by ESBL-producers in the community setting.

Original languageEnglish
Pages (from-to)127-133
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume45
Issue number2
DOIs
Publication statusPublished - 2012 Apr 1

Fingerprint

Klebsiella pneumoniae
beta-Lactamases
Escherichia coli
Community-Acquired Infections
Community Health Services
Fluoroquinolones
Aminoglycosides
Cross Infection
Taiwan
Urinary Tract Infections
Comorbidity
Retrospective Studies
Delivery of Health Care
Mortality

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

@article{7fc8695540994969818353f10f02b4b4,
title = "Clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia and their emergence in the community",
abstract = "Background: The purpose of this study is to delineate clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) in different clinical settings, with an emphasis on community-acquired infections. Methods: A retrospective study was conducted at two medical centers in Taiwan. From May 2002 to August 2007, clinical data of adults with urosepsis caused by ESBL-EK were collected. Patients were categorized into three groups according to the place of acquisition. Baseline characteristics, microbiological data and clinical outcomes were compared. Results: Ninety-three cases of ESBL-EK urosepsis were included. Their mean age was 69.4 years, and 48.4{\%} were men. Eleven (11.8{\%}), 41 (44.1{\%}), and 41 (44.1{\%}) patients were categorized as having community-acquired, healthcare-associated, and hospital-acquired infections, respectively. Cases of ESBL-EK urosepsis from different settings shared similar characteristics in terms of age, gender, comorbidity and resistance profiles of bacterial strains. Of the bacterial isolates, 75{\%} and 38.7{\%} were resistant to fluoroquinolones and aminoglycosides, respectively. Cases of community-acquired urosepsis had a lower disease severity than those acquired in healthcare facilities or hospitals. Of note, there was no case fatality in 11 cases of community-acquired urosepsis and, in contrast, a crude mortality rate of 41.5{\%} was found among adults with hospital-acquired urosepsis (p < 0.001). Conclusion: A limited number of adults with community-acquired urosepsis caused by ESBL-EK in the present study had a favorable outcome. Nonetheless, clinicians should be cautious of the emergence of urinary tract infections caused by ESBL-producers in the community setting.",
author = "Jen-Chieh Lee and Nan-Yao Lee and Lee, {Hsin Chun} and Huang, {Wei Han} and Tsui, {Ko Chung} and Chia-Ming Chang and Lee, {Ching Chi} and Po-Lin Chen and Wu, {Chi Jung} and Hsueh, {Po Ren} and Wen-Chien Ko",
year = "2012",
month = "4",
day = "1",
doi = "10.1016/j.jmii.2011.09.029",
language = "English",
volume = "45",
pages = "127--133",
journal = "Journal of Microbiology, Immunology and Infection",
issn = "1684-1182",
publisher = "Elsevier Taiwan LLC",
number = "2",

}

TY - JOUR

T1 - Clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli or Klebsiella pneumonia and their emergence in the community

AU - Lee, Jen-Chieh

AU - Lee, Nan-Yao

AU - Lee, Hsin Chun

AU - Huang, Wei Han

AU - Tsui, Ko Chung

AU - Chang, Chia-Ming

AU - Lee, Ching Chi

AU - Chen, Po-Lin

AU - Wu, Chi Jung

AU - Hsueh, Po Ren

AU - Ko, Wen-Chien

PY - 2012/4/1

Y1 - 2012/4/1

N2 - Background: The purpose of this study is to delineate clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) in different clinical settings, with an emphasis on community-acquired infections. Methods: A retrospective study was conducted at two medical centers in Taiwan. From May 2002 to August 2007, clinical data of adults with urosepsis caused by ESBL-EK were collected. Patients were categorized into three groups according to the place of acquisition. Baseline characteristics, microbiological data and clinical outcomes were compared. Results: Ninety-three cases of ESBL-EK urosepsis were included. Their mean age was 69.4 years, and 48.4% were men. Eleven (11.8%), 41 (44.1%), and 41 (44.1%) patients were categorized as having community-acquired, healthcare-associated, and hospital-acquired infections, respectively. Cases of ESBL-EK urosepsis from different settings shared similar characteristics in terms of age, gender, comorbidity and resistance profiles of bacterial strains. Of the bacterial isolates, 75% and 38.7% were resistant to fluoroquinolones and aminoglycosides, respectively. Cases of community-acquired urosepsis had a lower disease severity than those acquired in healthcare facilities or hospitals. Of note, there was no case fatality in 11 cases of community-acquired urosepsis and, in contrast, a crude mortality rate of 41.5% was found among adults with hospital-acquired urosepsis (p < 0.001). Conclusion: A limited number of adults with community-acquired urosepsis caused by ESBL-EK in the present study had a favorable outcome. Nonetheless, clinicians should be cautious of the emergence of urinary tract infections caused by ESBL-producers in the community setting.

AB - Background: The purpose of this study is to delineate clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) in different clinical settings, with an emphasis on community-acquired infections. Methods: A retrospective study was conducted at two medical centers in Taiwan. From May 2002 to August 2007, clinical data of adults with urosepsis caused by ESBL-EK were collected. Patients were categorized into three groups according to the place of acquisition. Baseline characteristics, microbiological data and clinical outcomes were compared. Results: Ninety-three cases of ESBL-EK urosepsis were included. Their mean age was 69.4 years, and 48.4% were men. Eleven (11.8%), 41 (44.1%), and 41 (44.1%) patients were categorized as having community-acquired, healthcare-associated, and hospital-acquired infections, respectively. Cases of ESBL-EK urosepsis from different settings shared similar characteristics in terms of age, gender, comorbidity and resistance profiles of bacterial strains. Of the bacterial isolates, 75% and 38.7% were resistant to fluoroquinolones and aminoglycosides, respectively. Cases of community-acquired urosepsis had a lower disease severity than those acquired in healthcare facilities or hospitals. Of note, there was no case fatality in 11 cases of community-acquired urosepsis and, in contrast, a crude mortality rate of 41.5% was found among adults with hospital-acquired urosepsis (p < 0.001). Conclusion: A limited number of adults with community-acquired urosepsis caused by ESBL-EK in the present study had a favorable outcome. Nonetheless, clinicians should be cautious of the emergence of urinary tract infections caused by ESBL-producers in the community setting.

UR - http://www.scopus.com/inward/record.url?scp=84859817596&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859817596&partnerID=8YFLogxK

U2 - 10.1016/j.jmii.2011.09.029

DO - 10.1016/j.jmii.2011.09.029

M3 - Article

C2 - 22041167

AN - SCOPUS:84859817596

VL - 45

SP - 127

EP - 133

JO - Journal of Microbiology, Immunology and Infection

JF - Journal of Microbiology, Immunology and Infection

SN - 1684-1182

IS - 2

ER -