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

GLIMP investigators, Uffe Bødtger (Member of author group)

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalRespirology
ISSN1323-7799
DOIs
Publication statusE-pub ahead of print - 5. Aug 2019

Fingerprint

Klebsiella pneumoniae
Body Mass Index
Cross-Sectional Studies

Bibliographical note

Published 2019. This article is a U.S. Government work and is in the public domain in the USA.

Keywords

  • Enterobacteriaceae
  • community-acquired pneumonia
  • multidrug-resistance
  • prevalence
  • risk factors

Cite this

@article{03b29a9e015b4868b9eeb2296d994f97,
title = "Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia",
abstract = "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.",
keywords = "Enterobacteriaceae, community-acquired pneumonia, multidrug-resistance, prevalence, risk factors",
author = "David Villafuerte and Stefano Aliberti and Soni, {Nilam J} and Paola Faverio and Marcos, {Pedro J} and Wunderink, {Richard G} and Alejandro Rodriguez and Oriol Sibila and Francisco Sanz and Ignacio Martin-Loeches and Francesco Menzella and Reyes, {Luis F} and Mateja Jankovic and Marc Spielmanns and Restrepo, {Marcos I} and {GLIMP investigators} and Uffe B{\o}dtger",
note = "Published 2019. This article is a U.S. Government work and is in the public domain in the USA.",
year = "2019",
month = "8",
day = "5",
doi = "10.1111/resp.13663",
language = "English",
journal = "Respirology",
issn = "1323-7799",
publisher = "Wiley-Blackwell",

}

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia. / GLIMP investigators ; Bødtger, Uffe (Member of author group).

In: Respirology, 05.08.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

AU - Villafuerte, David

AU - Aliberti, Stefano

AU - Soni, Nilam J

AU - Faverio, Paola

AU - Marcos, Pedro J

AU - Wunderink, Richard G

AU - Rodriguez, Alejandro

AU - Sibila, Oriol

AU - Sanz, Francisco

AU - Martin-Loeches, Ignacio

AU - Menzella, Francesco

AU - Reyes, Luis F

AU - Jankovic, Mateja

AU - Spielmanns, Marc

AU - Restrepo, Marcos I

AU - GLIMP investigators

A2 - Bødtger, Uffe

N1 - Published 2019. This article is a U.S. Government work and is in the public domain in the USA.

PY - 2019/8/5

Y1 - 2019/8/5

N2 - 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.

AB - 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.

KW - Enterobacteriaceae

KW - community-acquired pneumonia

KW - multidrug-resistance

KW - prevalence

KW - risk factors

U2 - 10.1111/resp.13663

DO - 10.1111/resp.13663

M3 - Journal article

C2 - 31385399

JO - Respirology

JF - Respirology

SN - 1323-7799

ER -