Clinical characteristics and outcome of bacteraemia caused by Enterobacter cloacae and Klebsiella aerogenes : more similarities than differences

被引：19

作者：

Alvarez-Marin, Rocio ^{[1
,14
]}

Antonio Lepe, Jose ^{[1
]}

Gasch-Blasi, Oriol ^{[2
,3
]}

Manuel Rodriguez-Martinez, Jose ^{[4
]}

Calvo-Montes, Jorge ^{[5
]}

Lara-Contreras, Rosario ^{[6
]}

Martin-Gandul, Cecilia ^{[1
]}

Tubau-Quintano, Fe ^{[7
,8
]}

Eliecer Cano-Garcia, Maria ^{[5
]}

Rodriguez-Lopez, Fernando ^{[9
]}

Rodriguez-Bano, Jesus ^{[10
]}

Pujol-Rojo, Miquel ^{[11
,12
]}

Torre-Cisneros, Julian ^{[6
]}

Martinez-Martinez, Luis ^{[5
,9
,13
]}

Pascual-Hernandez, Alvaro ^{[4
]}

Jimenez-Mejias, Manuel E. ^{[1
]}

机构：

[1] Univ Seville, Clin Unit Infect Dis Microbiol & Prevent Med, Infect Dis Res Grp, Inst Biomed Seville IBiS,CSIC,Virgen del Rocio Un, Seville, Spain

[2] Hosp Univ Parc Tauli, Infect Dis Serv, Inst Invest & Innovacio Parc Tauti I3PT, Sabadell, Spain

[3] Spanish Network Res Infect Dis, Madrid, Spain

[4] Virgen Macarena Univ Hosp, Dept Microbiol, Seville, Spain

[5] Marques de Valdecilla Univ Hosp IDIVAL, Dept Microbiol, Santander, Spain

[6] Univ Cordoba, Reina Sofia Univ Hosp, Clin Unit Infect Dis, Maimonides Biomed Res Inst Cordoba IMIBIC, Cordoba, Spain

[7] Univ Hosp Bellvitge, Dept Microbiol, Barcelona, Spain

[8] Inst Salud Carlos III, CIBER Resp Dis CIBERes, Madrid, Spain

[9] Univ Cordoba, Dept Microbiol, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Cordoba, Spain

[10] Univ Seville, Inst Biomed Seville IBiS, Virgen Macarena Univ Hosp,CSIC, Dept Med,Clin Unit Infect Dis Microbiol & Prevent, Seville, Spain

[11] Inst Salud Carlos III ISCIII, Spanish Network Res Infect Dis REIPI RDI2 0015, Inst Catala Salut ICS HUB, Dept Infect Dis,Hosp Univ Bellvitge, Madrid, Spain

[12] Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain

[13] Univ Cantabria, Dept Mol Biol, Santander, Spain

[14] Avda Manuel Siurot S-N, Seville 41013, Spain

来源：

JOURNAL OF GLOBAL ANTIMICROBIAL RESISTANCE | 2021年 / 25卷

关键词：

Enterobacter cloacae; Klebsiella aerogenes; Enterobacter aerogenes; Bacteraemia; Case-control study; Quinolone resistance mechanism; MEDIATED QUINOLONE RESISTANCE; GRAM-NEGATIVE BACTEREMIA; RISK-FACTORS; NOSOCOMIAL INFECTIONS; ANTIMICROBIAL THERAPY; MULTIPLEX PCR; MORTALITY; SPP; DEFINITIONS; PREDICTORS;

D O I：

10.1016/j.jgar.2021.04.008

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: The genus Enterobacter is a common cause of nosocomial infections. Historically, the most frequent Enterobacter species were those of Enterobacter cloacae complex and Enterobacter aerogenes. In 2019, E. aerogenes was re-classified as Klebsiella aerogenes owing to its higher genotypic similarity with the genus Klebsiella. Our objective was to characterise and compare the clinical profiles of bacteraemia caused by E. cloacae and K. aerogenes. Methods: This 3-year multicentre, prospective cohort study enrolled consecutive patients with bacteraemia by E. cloacae or K. aerogenes. Baseline characteristics, bacteraemia features (source, severity, treatment), antibiotic susceptibility, resistance mechanisms and mortality were analysed. Results: The study included 285 patients with bacteraemia [196 (68.8%) E. cloacae and 89 (31.2%) K. aerogenes]. The groups showed no differences in age, sex, previous use of invasive devices, place of acquisition, sources or severity at onset. The Charlson score was higher among patients with E. cloacae bacteraemia [2 (1-4) vs. 1 (0.5-3); P = 0.018], and previous antibiotic therapy was more common in patients with K. aerogenes bacteraemia (57.3% vs. 41.3%; P = 0.01). Mortality was 19.4% for E. cloacae and 20.2% for K. aerogenes ( P = 0.869). Antibiotic susceptibility was similar for both species, and the incidence of multidrug resistance or ESBL production was low (6% and 5.3%, respectively), with no differences between species. Conclusion: Bacteraemias caused by E. cloacae and K. aerogenes share similar patient profiles, presentation and prognosis. Patients with E. cloacae bacteraemia had more co-morbidities and those with K. aerogenes bacteraemia had received more antibiotics. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

引用

页码：351 / 358

页数：8

共 39 条

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