Abstract
Bacteremias caused by Klebsiella pneumoniae producing extended-spectrum beta-lactamase (ESBL-KP; n = 52) and producing both ESBL and AmpC-type DHA-1 beta-lactamase (ESBL-PMABL-KP; n = 20) were analyzed. Higher MIC(50)s and MIC(90)s for carbapenems, ciprofloxacin, and piperacillin-tazobactam were observed with ESBL-PMABL-KP than with ESBL-KP. Patients with oxyimino-β-lactam exposure and high modified Pitt bacteremia scores (HMPBSs) were at higher risk, while those with piperacillin-tazobactam and aminoglycoside exposure were at lower risk for ESBL-KP bacteremia. Patients with fluoroquinolone exposure, diabetes mellitus, and HMPBS were at higher risk, while those with aminoglycoside exposure were at lower risk, for ESBL-PMABL-KP bacteremia.
Publication types
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Adult
-
Aged
-
Aged, 80 and over
-
Anti-Bacterial Agents / therapeutic use
-
Bacteremia / drug therapy
-
Bacteremia / microbiology*
-
Bacterial Proteins / genetics
-
Bacterial Proteins / metabolism*
-
Carbapenems / therapeutic use
-
Case-Control Studies
-
Ciprofloxacin / therapeutic use
-
Female
-
Humans
-
Klebsiella pneumoniae / drug effects
-
Klebsiella pneumoniae / enzymology*
-
Klebsiella pneumoniae / genetics
-
Klebsiella pneumoniae / pathogenicity*
-
Male
-
Middle Aged
-
Penicillanic Acid / analogs & derivatives
-
Penicillanic Acid / therapeutic use
-
Piperacillin / therapeutic use
-
Piperacillin, Tazobactam Drug Combination
-
Plasmids / genetics
-
Young Adult
-
beta-Lactamases / genetics
-
beta-Lactamases / metabolism*
Substances
-
Anti-Bacterial Agents
-
Bacterial Proteins
-
Carbapenems
-
Piperacillin, Tazobactam Drug Combination
-
Ciprofloxacin
-
Penicillanic Acid
-
AmpC beta-lactamases
-
beta-Lactamases
-
Piperacillin