Molecular Correlation for the Treatment Outcomes in Bloodstream Infections Caused byEscherichia coliandKlebsiella pneumoniaewith Reduced Susceptibility to Ceftazidime
Open Access
- 15 January 2002
- journal article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 34 (2), 135-146
- https://doi.org/10.1086/324742
Abstract
Data are limited on outcomes of treatment with extended-spectrum cephalosporins (ESCs) for infections caused by Enterobacteriaceae that produce extended-spectrum β-lactamases (ESBLs). This study describes the largest treatment experience of a nonoutbreak series of bloodstream infections caused by strains of Escherichia coli (23 episodes) and Klebsiella pneumoniae (13 episodes) with a ceftazidime minimal inhibitory concentration of ⩾2 µg/mL. E. coli isolates produced a greater variety of β-lactamase types than did K. pneumoniae isolates, among which ESBL production was predominant. Five ESBL types were identified: TEM-12, TEM-71, TEM-6, SHV-12, and SHV-5. Most patients were treated empirically with an ESC-based regimen. A favorable response to treatment with a nonceftazidime ESC was observed when the causative pathogen produced either TEM-6 or TEM-12; ceftazidime treatment was associated with failure of therapy in all patients. Despite the limited clinical success, ESCs are currently not recommended for the treatment of serious infections caused by ESBL-producing strains.This publication has 22 references indexed in Scilit:
- Fatal Infection Due to Extended‐Spectrum Beta‐Lactamase‐Producing Escherichia coli: Implications for Antibiotic Choice for Spontaneous Bacterial PeritonitisClinical Infectious Diseases, 1999
- Is it important to identify extended-spectrum beta-lactamase-producing isolates?European Journal of Clinical Microbiology & Infectious Diseases, 1996
- Treatment failure due to extended spectrum βlactamaseJournal of Antimicrobial Chemotherapy, 1996
- beta-Lactamases in laboratory and clinical resistanceClinical Microbiology Reviews, 1995
- Treatment of a meningitis due to an Enterobacter aerogenes producing a derepressed cephalosporinase and a klebsiella pneumoniae producing an extended-spectrum β-lactamaseInfection, 1991
- Properties of plasmids responsible for production of extended-spectrum beta-lactamasesAntimicrobial Agents and Chemotherapy, 1991
- Failure of ceftazidime-amikacin therapy for bacteremia and meningitis due to Klebsiella pneumoniae producing an extended-spectrum beta-lactamaseAntimicrobial Agents and Chemotherapy, 1990
- Novel plasmid-mediated beta-lactamase (TEM-10) conferring selective resistance to ceftazidime and aztreonam in clinical isolates of Klebsiella pneumoniaeAntimicrobial Agents and Chemotherapy, 1989
- CDC definitions for nosocomial infections, 1988American Journal of Infection Control, 1988
- Novel β-lactamase in a clinical isolate of Klebsiella pneumoniae conferring unusual resistance to β-lactam antibioticsJournal of Antimicrobial Chemotherapy, 1987