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Extended‐Spectrum ß‐Lactamase–Producing Escherichia coli and Klebsiella Species: Risk Factors for Colonization and Impact of Antimicrobial Formulary Interventions on Colonization Prevalence
Formats Available in JSTOR: PDF
Abstract(back to top)
OBJECTIVE. The incidence of extended‐spectrum ß‐lactamase (ESßL)–mediated resistance has increased markedly during the past decade. Risk factors for colonization with ESßL‐producing Escherichia coli and Klebsiella species (ESßL‐EK) remain unclear, as do methods to control their further emergence.
DESIGN. Case–control study.
SETTING. Two hospitals within a large academic health system: a 725‐bed academic tertiary‐care medical center and a 344‐bed urban community hospital.
PATIENTS. Thirteen patients with ESßL‐EK fecal colonization were compared with 46 randomly selected noncolonized controls.
RESULTS. Duration of hospitalization was the only independent risk factor for ESßL‐EK colonization (odds ratio, 1.11; 95% confidence interval, 1.02 to 1.21). Of note, 8 (62%) of the patients had been admitted from another healthcare facility. In addition, there was evidence for dissemination of a single K. oxytoca clone. Finally, the prevalence of ESßL‐EK colonization decreased from 7.9% to 5.7% following restriction of third‐generation cephalosporins (P = .51).
CONCLUSIONS. ESßL‐EK colonization was associated only with duration of hospitalization and there was no significant reduction following antimicrobial formulary interventions. The evidence for nosocomial spread and the high percentage of patients with ESßL‐EK admitted from other sites suggest that greater emphasis must be placed on controlling the spread of such organisms within and between institutions.
Bibliographic Information(back to top)
- Extended‐Spectrum ß‐Lactamase–Producing Escherichia coli and Klebsiella Species: Risk Factors for Colonization and Impact of Antimicrobial Formulary Interventions on Colonization Prevalence
- Gregory Bisson , MD, Neil O. Fishman , MD, Jean Baldus Patel , PhD, Paul H. Edelstein , MD and Ebbing Lautenbach , MD, MPH
- Infection Control and Hospital Epidemiology
- Vol. 23, No. 5 (May 2002) (pp. 254-260)
Notes and References(back to top)
This item contains 1 note(s).
Notes
Drs. Bisson, Fishman, and Lautenbach are from the Division of Infectious Diseases, Department of Medicine; Drs. Patel and Edelstein are from the Department of Pathology and Laboratory Medicine; and Dr. Lautenbach is also from the Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, and the University of Pennsylvania Center for Education and Research on Therapeutics (CERTs), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. Address reprint requests to Ebbing Lautenbach, MD, MPH, University of Pennsylvania School of Medicine, Center for Clinical Epidemiology and Biostatistics, 825 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104‐6021. Presented in part at the 4th Decennial International Conference on Nosocomial and Healthcare‐Associated Infections; March 5‐9, 2000; Atlanta, GA.
Items Citing this Item (back to top)
10 item(s) in JSTOR cite this item
- Emily P. Hyle , MD; Warren B. Bilker , PhD; Leanne B. Gasink , MD, MSCE; Ebbing Lautenbach , MD, MPH, MSCEVol. 28, No. 6 (June 2007) pp. 647-654Stable URL: http://www.jstor.org/stable/10.1086/516798
- Robert C. Owens, Jr., Louis RiceVol. 42, Supplement 4. Developing Strategies to Minimize the Impact of Extended-Spectrum β-Lactamases (Apr. 15, 2006) pp. S173-S181Stable URL: http://www.jstor.org/stable/4484705
- Adam D. Lipworth , BA; Emily P. Hyle , BS; Neil O. Fishman , MD; Irving Nachamkin , DrPH, MPH; Warren B. Bilker , PhD; Ann Marie Marr , PharmD; Lori A. Larosa , PharmD; Nishaminy Kasbekar , PharmD; Ebbing Lautenbach , MD, MPH, MSCEVol. 27, No. 3 (March 2006) pp. 279-286Stable URL: http://www.jstor.org/stable/10.1086/503016
- Jesús Rodríguez-Baño, Maria D. Navarro, Luisa Romero, Miguel A. Muniain, Evelio J. Perea, Ramón Pérez-Cano, Jose R. Hernández, Alvaro PascualVol. 42, No. 1 (Jan. 1, 2006) pp. 37-45Stable URL: http://www.jstor.org/stable/4484507
- Rebecca H. Sunenshine , MD; Laura A. Liedtke , MS; Scott K. Fridkin , MD; Larry J. Strausbaugh , MD; TheVol. 26, No. 2 (February 2005) pp. 138-143Stable URL: http://www.jstor.org/stable/10.1086/502517
- Archana Chatterjee , MD, PhD; Brenda Heybrock , RN; Sharon Plummer , RN, CIC; Kay Eischen , RN, MSVol. 25, No. 9 (September 2004) pp. 786-788Stable URL: http://www.jstor.org/stable/10.1086/502479
- Aglai Arantes , MD; Eduardo da Silva Carvalho , PhD; Eduardo A. S. Medeiros , PhD; Calil Kairalla Farhat , PhD; Orlando Cesar Mantese , PhDVol. 25, No. 9 (September 2004) pp. 783-785Stable URL: http://www.jstor.org/stable/10.1086/502478
- Darren R. Linkin , MD; Neil O. Fishman , MD; Jean Baldus Patel , PhD, (D)ABMM; Jeffrey D. Merrill , MD; Ebbing Lautenbach , MD, MPH, MSCEVol. 25, No. 9 (September 2004) pp. 781-783Stable URL: http://www.jstor.org/stable/10.1086/502477
- Yaron Finkelstein , MD; Henia Elenberg , MA, RN; Gabriel Chodick , MSc, MHA; Vered Hoffer , MD; Itamar Shalit , MD; Ben‐Zion Garty , MDVol. 25, No. 9 (September 2004) pp. 788-791Stable URL: http://www.jstor.org/stable/10.1086/502480
- Joumana N. Samaha-Kfoury, George F. ArajVol. 327, No. 7425 (Nov. 22, 2003) pp. 1209-1213Stable URL: http://www.jstor.org/stable/25457837