Document Detail


Retrospective analysis of clinical and microbiological aspects of Klebsiella oxytoca bacteremia over a 10-year period.
MedLine Citation:
PMID:  12111596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From 1991 to 2000, 125 sporadic cases of Klebsiella oxytoca bacteremia were analyzed retrospectively to review clinical features and to identify the risk factors associated with resistance to extended-spectrum cephalosporins and fatal outcome. Bacteremia was acquired nosocomially in 52% of the patients. Almost all patients (97%) had an underlying disease, with biliary and pancreatic disease occurring most frequently (55%). The biliary tract was the most common site of infection (44%). Resistance to extended-spectrum cephalosporins was identified in 22 of the 125 (18%) Klebsiella oxytoca blood isolates and resistance to ciprofloxacin in 9 (7%). Only previous antibiotic therapy was strongly associated with resistance to extended-spectrum cephalosporins in patients with Klebsiella oxytoca bacteremia ( P=0.009). The mortality rate was 24% and was higher in patients infected with isolates resistant to extended-spectrum cephalosporins (41% vs. 20%; P=0.04). In multivariate analysis, fatal outcome was independently associated with septic shock, deteriorated mental status, polymicrobial bacteremia, and solid tumor. Surgical therapy had a protective effect (OR, 0.06; 95% CI, 0.005-0.7; P=0.03). In conclusion, Klebsiella oxytoca bacteremia was most commonly associated with biliary tract infection. Previous antibiotic therapy was strongly associated with resistance to extended-spectrum cephalosporins in patients with Klebsiella oxytoca bacteremia.
Authors:
B N Kim; J Ryu; Y S Kim; J H Woo
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Publication Detail:
Type:  Journal Article     Date:  2002-06-12
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  21     ISSN:  0934-9723     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-07-11     Completed Date:  2002-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  419-26     Citation Subset:  IM    
Affiliation:
Division of Infectious Diseases, Asan Medical Center, and Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents / pharmacology*,  therapeutic use
Bacteremia* / drug therapy,  microbiology,  mortality,  physiopathology
Cephalosporins / pharmacology*,  therapeutic use
Child
Child, Preschool
Drug Resistance, Bacterial
Female
Humans
Infant
Infant, Newborn
Klebsiella* / drug effects,  pathogenicity
Klebsiella Infections* / drug therapy,  microbiology,  mortality,  physiopathology
Male
Microbial Sensitivity Tests
Middle Aged
Retrospective Studies
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Cephalosporins

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