Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia
Introduction: Extended spectrum beta-lactamases (ESBL) produced by gram-negative bacteria have been associated with increased hospital morbidity and mortality, longer hospital stays, use of carbapenems, and higher health care costs. Few studies have assessed the risk factors for infection by ESBL-pr...
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| Format: | Article |
| Language: | English |
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Universidad Nacional de Colombia
2021-10-01
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| Series: | Revista de la Facultad de Medicina |
| Subjects: | |
| Online Access: | https://revistas.unal.edu.co/index.php/revfacmed/article/view/92755 |
| _version_ | 1797824740100931584 |
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| author | Juan Pablo Camargo-Mendoza Daniel Efrén Ariza-Rodríguez |
| author_facet | Juan Pablo Camargo-Mendoza Daniel Efrén Ariza-Rodríguez |
| author_sort | Juan Pablo Camargo-Mendoza |
| collection | DOAJ |
| description | Introduction: Extended spectrum beta-lactamases (ESBL) produced by gram-negative bacteria have been associated with increased hospital morbidity and mortality, longer hospital stays, use of carbapenems, and higher health care costs. Few studies have assessed the risk factors for infection by ESBL-producing germs in intensive care units (ICU).
Objective: To determine the risk factors for healthcare-associated infections (HAIs) by ESBL-producing Klebsiella pneumoniae and Escherichia coli in an ICU of a public tertiary care hospital and to assess the impact of this type of infection on mortality.
Materials and methods: A case-control study with a 1:2 ratio (97 cases and 194 controls) was conducted in critically ill patients admitted to the ICU of a public tertiary care hospital in Bogotá D.C. (Colombia) between January 2016 and December 2019, and in which a HAI by ESBL-producing K. pneumoniae or E. coli (cases: n=97) or K. pneumoniae or E. coli with a normal antibiotic resistance pattern (controls: n=194) was documented. Bivariate analyses were performed using the chi-squared and the Mann-Whitney U tests. A logistic regression model was used in the multivariate analysis, and a two-tailed test was performed with the p-values obtained in the bivariate analyses.
Results: ESBL-producing K. pneumoniae and E. coli isolates were identified in 57 (58.76%) and 40 (41.24%) patients, respectively. These isolates were obtained mainly from urine samples (30,92%), followed by peritoneal fluid (27.80%). In the multivariate analysis, the presence of urinary tract infection on admission to the ICU was identified as a risk factor (OR=5.63, 95%CI: 1.918-16.53;; p=0.002). The mortality rate was 28.17% (26.29% in the controls and 31.95% in the cases), but no significant difference was observed between groups (p=0.311).
Conclusion: Urinary tract infection on admission to the ICU was a risk factor for HAIs by ESBL-producing K. pneumoniae or E. coli. Furthermore, no significant difference was observed between cases and controls in terms of mortality.
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| first_indexed | 2024-03-13T10:43:40Z |
| format | Article |
| id | doaj.art-e20df4f446f5453faf8378bc1f165882 |
| institution | Directory Open Access Journal |
| issn | 0120-0011 2357-3848 |
| language | English |
| last_indexed | 2024-03-13T10:43:40Z |
| publishDate | 2021-10-01 |
| publisher | Universidad Nacional de Colombia |
| record_format | Article |
| series | Revista de la Facultad de Medicina |
| spelling | doaj.art-e20df4f446f5453faf8378bc1f1658822023-05-17T22:02:47ZengUniversidad Nacional de ColombiaRevista de la Facultad de Medicina0120-00112357-38482021-10-0170410.15446/revfacmed.v70n4.92755Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., ColombiaJuan Pablo Camargo-Mendoza0Daniel Efrén Ariza-Rodríguez1Hospital de Kennedy - Intensive Care Unit - Bogotá D.C. - Colombia.Hospital de Kennedy - Intensive Care Unit - Bogotá D.C. - Colombia.Introduction: Extended spectrum beta-lactamases (ESBL) produced by gram-negative bacteria have been associated with increased hospital morbidity and mortality, longer hospital stays, use of carbapenems, and higher health care costs. Few studies have assessed the risk factors for infection by ESBL-producing germs in intensive care units (ICU). Objective: To determine the risk factors for healthcare-associated infections (HAIs) by ESBL-producing Klebsiella pneumoniae and Escherichia coli in an ICU of a public tertiary care hospital and to assess the impact of this type of infection on mortality. Materials and methods: A case-control study with a 1:2 ratio (97 cases and 194 controls) was conducted in critically ill patients admitted to the ICU of a public tertiary care hospital in Bogotá D.C. (Colombia) between January 2016 and December 2019, and in which a HAI by ESBL-producing K. pneumoniae or E. coli (cases: n=97) or K. pneumoniae or E. coli with a normal antibiotic resistance pattern (controls: n=194) was documented. Bivariate analyses were performed using the chi-squared and the Mann-Whitney U tests. A logistic regression model was used in the multivariate analysis, and a two-tailed test was performed with the p-values obtained in the bivariate analyses. Results: ESBL-producing K. pneumoniae and E. coli isolates were identified in 57 (58.76%) and 40 (41.24%) patients, respectively. These isolates were obtained mainly from urine samples (30,92%), followed by peritoneal fluid (27.80%). In the multivariate analysis, the presence of urinary tract infection on admission to the ICU was identified as a risk factor (OR=5.63, 95%CI: 1.918-16.53;; p=0.002). The mortality rate was 28.17% (26.29% in the controls and 31.95% in the cases), but no significant difference was observed between groups (p=0.311). Conclusion: Urinary tract infection on admission to the ICU was a risk factor for HAIs by ESBL-producing K. pneumoniae or E. coli. Furthermore, no significant difference was observed between cases and controls in terms of mortality. https://revistas.unal.edu.co/index.php/revfacmed/article/view/92755Beta-LactamasesKlebsiella PneumoniaeEscherichia ColiRisk FactorsIntensive Care UnitAntibiotics |
| spellingShingle | Juan Pablo Camargo-Mendoza Daniel Efrén Ariza-Rodríguez Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia Revista de la Facultad de Medicina Beta-Lactamases Klebsiella Pneumoniae Escherichia Coli Risk Factors Intensive Care Unit Antibiotics |
| title | Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia |
| title_full | Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia |
| title_fullStr | Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia |
| title_full_unstemmed | Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia |
| title_short | Risk factors for health care-associated infections by ESBL-producing germs in an intensive care unit of a public hospital in Bogotá D.C., Colombia |
| title_sort | risk factors for health care associated infections by esbl producing germs in an intensive care unit of a public hospital in bogota d c colombia |
| topic | Beta-Lactamases Klebsiella Pneumoniae Escherichia Coli Risk Factors Intensive Care Unit Antibiotics |
| url | https://revistas.unal.edu.co/index.php/revfacmed/article/view/92755 |
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