@article{10902/5739,
year = {2012},
month = {10},
url = {http://hdl.handle.net/10902/5739},
abstract = {BACKGROUND: 

The objective of this study is to analyze the factors that are associated with the adequacy of empirical antibiotic therapy and its impact in mortality in a large cohort of patients with extended-spectrum β-lactamase (ESBL)--producing Escherichia coli and Klebsiella spp. bacteremia.

METHODS: 

Cases of ESBL producing Enterobacteriaceae (ESBL-E) bacteremia collected from 2003 through 2008 in 19 hospitals in Spain. Statistical analysis was performed using multivariate logistic regression.

RESULTS: 

We analyzed 387 cases ESBL-E bloodstream infections. The main sources of bacteremia were urinary tract (55.3%), biliary tract (12.7%), intra-abdominal (8.8%) and unknown origin (9.6%). Among all the 387 episodes, E. coli was isolated from blood cultures in 343 and in 45.71% the ESBL-E was multidrug resistant. Empirical antibiotic treatment was adequate in 48.8% of the cases and the in hospital mortality was 20.9%. In a multivariate analysis adequacy was a risk factor for death [adjusted OR (95% CI): 0.39 (0.31-0.97); P = 0.04], but not in patients without severe sepsis or shock. The class of antibiotic used empirically was not associated with prognosis in adequately treated patients.

CONCLUSION: 

ESBL-E bacteremia has a relatively high mortality that is partly related with a low adequacy of empirical antibiotic treatment. In selected subgroups the relevance of the adequacy of empirical therapy is limited.},
publisher = {BioMed Central},
publisher = {BMC Infectious Diseases. 2012 Oct 5;12:245},
title = {Impact of empirical treatment in extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. bacteremia. A multicentric cohort study},
author = {Peralta Fernández, Francisco Galo and Lamelo Otero, María and Álvarez García, Patricia and Velasco Arribas, María and Delgado-Iribarren, Alberto and Horcajada Gallego, Juan Pablo and Montero, María Milagro and Roiz Mesones, María Pía and Fariñas Álvarez, María del Carmen and Alonso Gutiérrez, Juan and Martínez Martínez, Luis and Gutiérrez Macías, Alfonso and Álava Menica, José Ángel and Rodríguez Guardado, Azucena and Fleites, Ana and Navarro López, Vicente and Sirvent Quílez, Elia and Capdevila Morell, José Antonio},
}