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タイトル: | Cefotaxime for the detection of extended-spectrum β-lactamase or plasmid-mediated AmpC β-lactamase and clinical characteristics of cefotaxime-non-susceptible Escherichia coli and Klebsiella pneumoniae bacteraemia. |
著者: | Matsumura, Y https://orcid.org/0000-0001-8595-8944 (unconfirmed) Yamamoto, M Matsushima, A Nagao, M https://orcid.org/0000-0002-8886-6145 (unconfirmed) Ito, Y Takakura, S Ichiyama, S |
著者名の別形: | 松村, 康史 |
キーワード: | cefotaxime bloodstream infection risk factor prognosis ESBL AmpC |
発行日: | 1-Aug-2012 |
出版者: | Springer-Verlag |
誌名: | European journal of clinical microbiology & infectious diseases |
巻: | 31 |
号: | 8 |
開始ページ: | 1931 |
終了ページ: | 1939 |
抄録: | We investigated the performance of cefotaxime for the detection of extended-spectrum β-lactamase (ESBL) or plasmid-mediated AmpC β-lactamase (pAmpC) and the clinical characteristics of cefotaxime-non-susceptible Escherichia coli or Klebsiella pneumoniae (CTXNS-EK) bacteraemia. All of the consecutive bloodstream isolates between 2005 and 2010 in a Japanese university hospital were characterised using polymerase chain reaction (PCR). Risk factors and outcomes of CTXNS-EK were analysed by multivariate logistic regression analysis. We identified 58 CTXNS-EK (15.6%) from 249 E. coli and 122 K. pneumoniae. Cefotaxime with a minimum inhibitory concentration (MIC) of >1 μg/mL had a sensitivity of 98.3% and a specificity of 99.7% for the detection of ESBL or pAmpC. CTXNS-EK had increased from 4.5% in 2005 to 23% in 2009. Risk factors for CTXNS-EK were previous isolation of multidrug-resistant bacteria, use of oxyimino-cephalosporins or fluoroquinolones, and high Sequential Organ Failure Assessment (SOFA) score. Patients with CTXNS-EK bacteraemia less frequently received appropriate empirical therapy than patients with cefotaxime-susceptible EK bacteraemia (81% vs. 97%, p<0.001) and died within 30 days (21% vs. 5%, p=0.001). Using the current breakpoints of the Clinical and Laboratory Standards Institute (CLSI) or the European Committee on Antimicrobial Susceptibility Testing (EUCAST), cefotaxime alone can identify ESBL or pAmpC producers. CTXNS-EK is an important and increasingly prevalent bacteraemia pathogen. |
著作権等: | The final publication is available at link.springer.com この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 This is not the published version. Please cite only the published version. |
URI: | http://hdl.handle.net/2433/178037 |
DOI(出版社版): | 10.1007/s10096-011-1523-4 |
PubMed ID: | 22210267 |
出現コレクション: | 学術雑誌掲載論文等 |
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