Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND AND OBJECTIVE: Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. METHODS: We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. RESULTS: Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. CONCLUSION: This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

Full Text

Duke Authors

Cited Authors

  • Villafuerte, D; Aliberti, S; Soni, NJ; Faverio, P; Marcos, PJ; Wunderink, RG; Rodriguez, A; Sibila, O; Sanz, F; Martin-Loeches, I; Menzella, F; Reyes, LF; Jankovic, M; Spielmanns, M; Restrepo, MI; GLIMP Investigators,

Published Date

  • May 2020

Published In

Volume / Issue

  • 25 / 5

Start / End Page

  • 543 - 551

PubMed ID

  • 31385399

Electronic International Standard Serial Number (EISSN)

  • 1440-1843

Digital Object Identifier (DOI)

  • 10.1111/resp.13663

Language

  • eng

Conference Location

  • Australia