Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit
BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis adm...
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| Format: | Article |
| Language: | English |
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Korean Society of Critical Care Medicine
2014-11-01
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| Series: | Korean Journal of Critical Care Medicine |
| Subjects: | |
| Online Access: | http://www.kjccm.org/upload/pdf/kjccm-2014-29-4-257.pdf |
| _version_ | 1798044476946513920 |
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| author | Bumjoon Kim Sung Gyun Kim Seung Soon Lee Tae Seok Kim Yong Il Hwang Seung Hun Jang Joo Hee Kim Ki Suck Jung Sunghoon Park |
| author_facet | Bumjoon Kim Sung Gyun Kim Seung Soon Lee Tae Seok Kim Yong Il Hwang Seung Hun Jang Joo Hee Kim Ki Suck Jung Sunghoon Park |
| author_sort | Bumjoon Kim |
| collection | DOAJ |
| description | BACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting.
METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome.
RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs.
10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production.
CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting. |
| first_indexed | 2024-04-11T23:04:27Z |
| format | Article |
| id | doaj.art-f45da5265a774f83ba31345e4b0f3122 |
| institution | Directory Open Access Journal |
| issn | 2383-4870 |
| language | English |
| last_indexed | 2024-04-11T23:04:27Z |
| publishDate | 2014-11-01 |
| publisher | Korean Society of Critical Care Medicine |
| record_format | Article |
| series | Korean Journal of Critical Care Medicine |
| spelling | doaj.art-f45da5265a774f83ba31345e4b0f31222022-12-22T03:58:03ZengKorean Society of Critical Care MedicineKorean Journal of Critical Care Medicine2383-48702014-11-0129425726510.4266/kjccm.2014.29.4.257112Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care UnitBumjoon KimSung Gyun KimSeung Soon LeeTae Seok KimYong Il HwangSeung Hun JangJoo Hee KimKi Suck JungSunghoon ParkBACKGROUND: The role of extended-spectrum beta-lactamase (ESBL)-producing or multidrug-resistant (MDR) organisms in patients with sepsis secondary to urinary traction infection (UTI) has not been investigated extensively in the intensive care unit (ICU) setting. METHODS: Patients with UTI sepsis admitted to the ICU were retrospectively enrolled in this study (January 2009-December 2012). We investigated the impact of ESBL-producing and ESBL-negative MDR organisms on hospital outcome. RESULTS: In total, 94 patients were enrolled (median age, 73.0 years; female, 81.9%), and ESBL-producing and ESBL-negative MDR organisms accounted for 20.2% (n = 19) and 30.9% (n = 29), respectively. Both patients with ESBL-producing and ESBL-negative MDR organisms were more likely to experience a delay in adequate antibiotic therapy than those with non-ESBL/non-MDR organisms (p < 0.001 and p = 0.032, respectively). However, only patients with ESBL-producing organisms showed a higher mortality rate (ESBL vs. ESBL-negative MDR vs. non-ESBL/non-MDR, 31.6% vs. 10.3%.vs. 10.9%, respectively). In multivariate analyses, ESBL production was significantly associated with hospital mortality (odds ratio, 11.547; 95micro confidence interval, 1.047-127.373), and prior admission was a significant predictor of ESBL production. CONCLUSIONS: Although both ESBL-producing and ESBL-negative MDR organisms are associated with delayed administration of appropriate antibiotics, only ESBL production is a significant predictor of hospital mortality among patients with UTI sepsis in the ICU setting.http://www.kjccm.org/upload/pdf/kjccm-2014-29-4-257.pdfbeta-lactamasedrug resistance, multipleintensive care unitssepsisurinary tract infections |
| spellingShingle | Bumjoon Kim Sung Gyun Kim Seung Soon Lee Tae Seok Kim Yong Il Hwang Seung Hun Jang Joo Hee Kim Ki Suck Jung Sunghoon Park Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit Korean Journal of Critical Care Medicine beta-lactamase drug resistance, multiple intensive care units sepsis urinary tract infections |
| title | Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit |
| title_full | Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit |
| title_fullStr | Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit |
| title_full_unstemmed | Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit |
| title_short | Extended-Spectrum beta-Lactamase and Multidrug Resistance in Urinary Sepsis Patients Admitted to the Intensive Care Unit |
| title_sort | extended spectrum beta lactamase and multidrug resistance in urinary sepsis patients admitted to the intensive care unit |
| topic | beta-lactamase drug resistance, multiple intensive care units sepsis urinary tract infections |
| url | http://www.kjccm.org/upload/pdf/kjccm-2014-29-4-257.pdf |
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