Spread of Extended-Spectrum Beta-Lactamase-Producing Klebsiella Pneumoniae: Are Beta-Lactamase Inhibitors of Therapeutic Value?

Clin Infect Dis. 1998 Jul;27(1):76-80. doi: 10.1086/514643.

Abstract

Because of recurrent colonization by Klebsiella pneumoniae strains producing type SHV-4 extended-spectrum beta-lactamases (ESBLs), a case-control study was conducted in an intensive care unit to investigate the risk of acquisition, with special reference to antibiotic therapy and resuscitation procedures. Fifty-one patients colonized or infected by ESBL-producing K. pneumoniae (cases) were matched with 51 noncolonized patients (controls). Duration of intubation was significantly longer for cases than for controls, while duration of beta-lactamase inhibitor therapy was significantly shorter. By means of multivariate analysis, intubation was the only risk factor identified (odds ratio [OR] = 1.19), while beta-lactamase inhibitor therapy was shown to be a protective factor (OR = 0.849). During outbreaks of SHV-4 type ESBL-producing K. pneumoniae in intensive care units, preferential use of beta-lactamase inhibitors may help control the emergence and spread of these pathogens even if essential hand washing and isolation procedures are adhered to.

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Case-Control Studies
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / prevention & control*
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Intensive Care Units
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology
  • Klebsiella Infections / prevention & control*
  • Klebsiella pneumoniae / drug effects
  • Klebsiella pneumoniae / metabolism*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • beta-Lactamases / metabolism*

Substances

  • Anti-Bacterial Agents
  • beta-Lactamases