Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Villafuerte, D.; Aliberti, S.; Soni, N.J.; Faverio, P.; Marcos, P.J.; Wunderink, R.G.; Rodriguez, A.; Sibila, O.; Sanz, F.; Martin-Loeches, I.; Menzella, F.; Reyes, L.F.; Jankovic, M.; Spielmanns, M.; Restrepo, M.I.; Aruj, P.K.; Attorri, S.; Barimboim, E.; Caeiro, J.P.; Garzon, M.I.; Cambursano, V.H.; Ceccato, A.; Chertcoff, J.; Cordon Diaz, A.; de Vedia, L.; Ganaha, M.C.; Lambert, S.; Lopardo, G.; Luna, C.M.; Malberti, A.G.; Morcillo, N.; Tartara, S.; Pensotti, C.; Pereyra, B.; Scapellato, P.G.; Stagnaro, J.P.; Shah, S.; Lotsch, F.; Thalhammer, F.; Anseeuw, K.; Francois, C.A.; Van Braeckel, E.; Vincent, J.L.; Djimon, M.Z.; Nouer, S.A.; Chipev, P.; Encheva, M.; Miteva, D.; Petkova, D.; Balkissou, A.D.; Yone, E.W.P.; Ngahane, B.H.M.; Shen, N.; J. -F., X.; Rico, C.A.B.; Buitrago, R.; Paternina, F.J.P.; Ntumba, J.-.K.; Carevic, V.V.; Jakopovic, M.; Jankovic, M.; Matkovic, Z.; Mitrecic, I.; Jacobsson, M.-.B.; Christensen, A.B.; Heitmann Bodtger, U.C.; Meyer, C.N.; Jensen, A.V.; El-Said Abd El-Wahhab, I.; Morsy, N.E.; Shafiek, H.; Sobh, E.; Abdulsemed, K.A.; Bertrand, F.; Brun-Buisson, C.; Montmollin, E.D.; Fartoukh, M.; Messika, J.; Tattevin, P.; Khoury, A.; Ebruke, B.; Dreher, M.; Kolditz, M.; Meisinger, M.; Pletz, M.W.; Hagel, S.; Rupp, J.; Schaberg, T.; Spielmanns, M.; Creutz, P.; Suttorp, N.; Siaw-Lartey, B.; Dimakou, K.; Papapetrou, D.; Tsigou, E.; Ampazis, D.; Kaimakamis, E.; Bhatia, M.; Dhar, R.; D'Souza, G.; Garg, R.; Koul, P.A.; Mahesh, P.A.; Jayaraj, B.S.; Narayan, K.V.; Udnur, H.B.; Krishnamurthy, S.B.; Kant, S.; Swarnakar, R.; Limaye, S.; Salvi, S.; Golshani, K.; Keatings, V.M.; Martin-Loeches, I.; Maor, Y.; Strahilevitz, J.; Battaglia, S.; Carrabba, M.; Ceriana, P.; Confalonieri, M.; Monforte, A.D.; Prato, B.D.; Rosa, M.D.; Fantini, R.; Fiorentino, G.; Gammino, M.A.; Menzella, F.; Milani, G.; Nava, S.; Palmiero, G.; Petrino, R.; Gabrielli, B.; Rossi, P.; Sorino, C.; Steinhilber, G.; Zanforlin, A.; Franzetti, F.; Carone, M.; Patella, V.; Scarlata, S.; Comel, A.; Kurahashi, K.; Bacha, Z.A.; Ugalde, D.B.; Zuniga, O.C.; Villegas, J.F.; Medenica, M.; van de Garde, E.M.W.; Mihsra, D.R.; Shrestha, P.; Ridgeon, E.; Awokola, B.I.; Nwankwo, O.N.O.; Olufunlola, A.B.; Olumide, S.; Ukwaja, K.N.; Irfan, M.; Minarowski, L.; Szymon, S.; Froes, F.; Leuschner, P.; Meireles, M.; Ravara, S.B.; Brocovschii, V.; Ion, C.; Rusu, D.; Toma, C.; Chirita, D.; Dorobat, C.M.; Birkun, A.; Kaluzhenina, A.; Almotairi, A.; Bukhary, Z.A.A.; Edathodu, J.; Fathy, A.; Enani, A.M.A.; Mohamed, N.E.; Memon, J.U.; Bella, A.; Bogdanovic, N.; Milenkovic, B.; Pesut, D.; Borderias, L.; Garcia, N.M.B.; Cabello Alarcon, H.; Cilloniz, C.; Torres, A.; Diaz-Brito, V.; Casas, X.; Gonzalez, A.E.; Fernandez-Almira, M.L.; Gallego, M.; Gaspar-Garcia, I.; Castillo, J.G.D.; Victoria, P.J.; Laserna Martinez, E.; Molina, R.M.D.; Marcos, P.J.; Menendez, R.; Pando-Sandoval, A.; Aymerich, C.P.; Rello, J.; Moyano, S.; Sanz, F.; Sibila, O.; Rodrigo-Troyano, A.; Sole-Violan, J.; Uranga, A.; van Boven, J.F.M.; Torra, E.V.; Pujol, J.A.; Feldman, C.; Yum, H.K.; Fiogbe, A.A.; Yangui, F.; Bilaceroglu, S.; Dalar, L.; Yilmaz, U.; Bogomolov, A.; Elahi, N.; Dhasmana, D.J.; Feneley, A.; Hancock, C.; Hill, A.T.; Rudran, B.; Ruiz-Buitrago, S.; Campbell, M.; Whitaker, P.; Youzguin, A.; Singanayagam, A.; Allen, K.S.; Brito, V.; Dietz, J.; Dysart, C.E.; Kellie, S.M.; Franco-Sadud, R.A.; Meier, G.; Gaga, M.; Holland, T.L.; Bergin, S.P.; Kheir, F.; Landmeier, M.; Lois, M.; Nair, G.B.; Patel, H.; Reyes, K.; Rodriguez-Cintron, W.; Saito, S.; Soni, N.J.; Noda, J.; Hinojosa, C.I.; Levine, S.M.; Angel, L.F.; Anzueto, A.; Whitlow, K.S.; Hipskind, J.; Sukhija, K.; Totten, V.; Wunderink, R.G.; Shah, R.D.; Mateyo, K.J.; Noriega, L.; Alvarado, E.; Aman, M.; Labra, L.

doi:10.1111/resp.13663

Background and objective Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when >= 3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia / D. Villafuerte, S. Aliberti, N.J. Soni, P. Faverio, P.J. Marcos, R.G. Wunderink, A. Rodriguez, O. Sibila, F. Sanz, I. Martin-Loeches, F. Menzella, L.F. Reyes, M. Jankovic, M. Spielmanns, M.I. Restrepo, P.K. Aruj, S. Attorri, E. Barimboim, J.P. Caeiro, M.I. Garzon, V.H. Cambursano, A. Ceccato, J. Chertcoff, A. Cordon Diaz, L. de Vedia, M.C. Ganaha, S. Lambert, G. Lopardo, C.M. Luna, A.G. Malberti, N. Morcillo, S. Tartara, C. Pensotti, B. Pereyra, P.G. Scapellato, J.P. Stagnaro, S. Shah, F. Lotsch, F. Thalhammer, K. Anseeuw, C.A. Francois, E. Van Braeckel, J.L. Vincent, M.Z. Djimon, S.A. Nouer, P. Chipev, M. Encheva, D. Miteva, D. Petkova, A.D. Balkissou, E.W.P. Yone, B.H.M. Ngahane, N. Shen, J.-. Xu, C.A.B. Rico, R. Buitrago, F.J.P. Paternina, J.-.K. Ntumba, V.V. Carevic, M. Jakopovic, M. Jankovic, Z. Matkovic, I. Mitrecic, M.-.B. Jacobsson, A.B. Christensen, U.C. Heitmann Bodtger, C.N. Meyer, A.V. Jensen, I. El-Said Abd El-Wahhab, N.E. Morsy, H. Shafiek, E. Sobh, K.A. Abdulsemed, F. Bertrand, C. Brun-Buisson, E.D. Montmollin, M. Fartoukh, J. Messika, P. Tattevin, A. Khoury, B. Ebruke, M. Dreher, M. Kolditz, M. Meisinger, M.W. Pletz, S. Hagel, J. Rupp, T. Schaberg, M. Spielmanns, P. Creutz, N. Suttorp, B. Siaw-Lartey, K. Dimakou, D. Papapetrou, E. Tsigou, D. Ampazis, E. Kaimakamis, M. Bhatia, R. Dhar, G. D'Souza, R. Garg, P.A. Koul, P.A. Mahesh, B.S. Jayaraj, K.V. Narayan, H.B. Udnur, S.B. Krishnamurthy, S. Kant, R. Swarnakar, S. Limaye, S. Salvi, K. Golshani, V.M. Keatings, I. Martin-Loeches, Y. Maor, J. Strahilevitz, S. Battaglia, M. Carrabba, P. Ceriana, M. Confalonieri, A.D. Monforte, B.D. Prato, M.D. Rosa, R. Fantini, G. Fiorentino, M.A. Gammino, F. Menzella, G. Milani, S. Nava, G. Palmiero, R. Petrino, B. Gabrielli, P. Rossi, C. Sorino, G. Steinhilber, A. Zanforlin, F. Franzetti, M. Carone, V. Patella, S. Scarlata, A. Comel, K. Kurahashi, Z.A. Bacha, D.B. Ugalde, O.C. Zuniga, J.F. Villegas, M. Medenica, E.M.W. van de Garde, D.R. Mihsra, P. Shrestha, E. Ridgeon, B.I. Awokola, O.N.O. Nwankwo, A.B. Olufunlola, S. Olumide, K.N. Ukwaja, M. Irfan, L. Minarowski, S. Szymon, F. Froes, P. Leuschner, M. Meireles, S.B. Ravara, V. Brocovschii, C. Ion, D. Rusu, C. Toma, D. Chirita, C.M. Dorobat, A. Birkun, A. Kaluzhenina, A. Almotairi, Z.A.A. Bukhary, J. Edathodu, A. Fathy, A.M.A. Enani, N.E. Mohamed, J.U. Memon, A. Bella, N. Bogdanovic, B. Milenkovic, D. Pesut, L. Borderias, N.M.B. Garcia, H. Cabello Alarcon, C. Cilloniz, A. Torres, V. Diaz-Brito, X. Casas, A.E. Gonzalez, M.L. Fernandez-Almira, M. Gallego, I. Gaspar-Garcia, J.G.D. Castillo, P.J. Victoria, E. Laserna Martinez, R.M.D. Molina, P.J. Marcos, R. Menendez, A. Pando-Sandoval, C.P. Aymerich, J. Rello, S. Moyano, F. Sanz, O. Sibila, A. Rodrigo-Troyano, J. Sole-Violan, A. Uranga, J.F.M. van Boven, E.V. Torra, J.A. Pujol, C. Feldman, H.K. Yum, A.A. Fiogbe, F. Yangui, S. Bilaceroglu, L. Dalar, U. Yilmaz, A. Bogomolov, N. Elahi, D.J. Dhasmana, A. Feneley, C. Hancock, A.T. Hill, B. Rudran, S. Ruiz-Buitrago, M. Campbell, P. Whitaker, A. Youzguin, A. Singanayagam, K.S. Allen, V. Brito, J. Dietz, C.E. Dysart, S.M. Kellie, R.A. Franco-Sadud, G. Meier, M. Gaga, T.L. Holland, S.P. Bergin, F. Kheir, M. Landmeier, M. Lois, G.B. Nair, H. Patel, K. Reyes, W. Rodriguez-Cintron, S. Saito, N.J. Soni, J. Noda, C.I. Hinojosa, S.M. Levine, L.F. Angel, A. Anzueto, K.S. Whitlow, J. Hipskind, K. Sukhija, V. Totten, R.G. Wunderink, R.D. Shah, K.J. Mateyo, L. Noriega, E. Alvarado, M. Aman, L. Labra. - In: RESPIROLOGY. - ISSN 1440-1843. - (2019). [Epub ahead of print]

Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community-acquired pneumonia

Villafuerte D.;S. Aliberti^{Secondo

Conceptualization};Soni N. J.;Faverio P.;Marcos P. J.;Wunderink R. G.;Rodriguez A.;Sibila O.;Sanz F.;Martin-Loeches I.;Menzella F.;Reyes L. F.;Jankovic M.;Spielmanns M.;Restrepo M. I.;Aruj P. K.;Attorri S.;Barimboim E.;Caeiro J. P.;Garzon M. I.;Cambursano V. H.;Ceccato A.;Chertcoff J.;Cordon Diaz A.;de Vedia L.;Ganaha M. C.;Lambert S.;Lopardo G.;Luna C. M.;Malberti A. G.;Morcillo N.;Tartara S.;Pensotti C.;Pereyra B.;Scapellato P. G.;Stagnaro J. P.;Shah S.;Lotsch F.;Thalhammer F.;Anseeuw K.;Francois C. A.;Van Braeckel E.;Vincent J. L.;Djimon M. Z.;Nouer S. A.;Chipev P.;Encheva M.;Miteva D.;Petkova D.;Balkissou A. D.;Yone E. W. P.;Ngahane B. H. M.;Shen N.;Xu J. -F.;Rico C. A. B.;Buitrago R.;Paternina F. J. P.;Ntumba J. -M. K.;Carevic V. V.;Jakopovic M.;Jankovic M.;Matkovic Z.;Mitrecic I.;Jacobsson M. -L. B.;Christensen A. B.;Heitmann Bodtger U. C.;Meyer C. N.;Jensen A. V.;El-Said Abd El-Wahhab I.;Morsy N. E.;Shafiek H.;Sobh E.;Abdulsemed K. A.;Bertrand F.;Brun-Buisson C.;Montmollin E. D.;Fartoukh M.;Messika J.;Tattevin P.;Khoury A.;Ebruke B.;Dreher M.;Kolditz M.;Meisinger M.;Pletz M. W.;Hagel S.;Rupp J.;Schaberg T.;Spielmanns M.;Creutz P.;Suttorp N.;Siaw-Lartey B.;Dimakou K.;Papapetrou D.;Tsigou E.;Ampazis D.;Kaimakamis E.;Bhatia M.;Dhar R.;D'Souza G.;Garg R.;Koul P. A.;Mahesh P. A.;Jayaraj B. S.;Narayan K. V.;Udnur H. B.;Krishnamurthy S. B.;Kant S.;Swarnakar R.;Limaye S.;Salvi S.;Golshani K.;Keatings V. M.;Martin-Loeches I.;Maor Y.;Strahilevitz J.;Battaglia S.;M. Carrabba;Ceriana P.;Confalonieri M.;Monforte A. D.;Prato B. D.;Rosa M. D.;Fantini R.;Fiorentino G.;Gammino M. A.;Menzella F.;Milani G.;Nava S.;Palmiero G.;Petrino R.;Gabrielli B.;Rossi P.;Sorino C.;Steinhilber G.;Zanforlin A.;Franzetti F.;Carone M.;Patella V.;Scarlata S.;Comel A.;Kurahashi K.;Bacha Z. A.;Ugalde D. B.;Zuniga O. C.;Villegas J. F.;Medenica M.;van de Garde E. M. W.;Mihsra D. R.;Shrestha P.;Ridgeon E.;Awokola B. I.;Nwankwo O. N. O.;Olufunlola A. B.;Olumide S.;Ukwaja K. N.;Irfan M.;Minarowski L.;Szymon S.;Froes F.;Leuschner P.;Meireles M.;Ravara S. B.;Brocovschii V.;Ion C.;Rusu D.;Toma C.;Chirita D.;Dorobat C. M.;Birkun A.;Kaluzhenina A.;Almotairi A.;Bukhary Z. A. A.;Edathodu J.;Fathy A.;Enani A. M. A.;Mohamed N. E.;Memon J. U.;Bella A.;Bogdanovic N.;Milenkovic B.;Pesut D.;Borderias L.;Garcia N. M. B.;Cabello Alarcon H.;Cilloniz C.;Torres A.;Diaz-Brito V.;Casas X.;Gonzalez A. E.;Fernandez-Almira M. L.;Gallego M.;Gaspar-Garcia I.;Castillo J. G. D.;Victoria P. J.;Laserna Martinez E.;Molina R. M. D.;Marcos P. J.;Menendez R.;Pando-Sandoval A.;Aymerich C. P.;Rello J.;Moyano S.;Sanz F.;Sibila O.;Rodrigo-Troyano A.;Sole-Violan J.;Uranga A.;van Boven J. F. M.;Torra E. V.;Pujol J. A.;Feldman C.;Yum H. K.;Fiogbe A. A.;Yangui F.;Bilaceroglu S.;Dalar L.;Yilmaz U.;Bogomolov A.;Elahi N.;Dhasmana D. J.;Feneley A.;Hancock C.;Hill A. T.;Rudran B.;Ruiz-Buitrago S.;Campbell M.;Whitaker P.;Youzguin A.;Singanayagam A.;Allen K. S.;Brito V.;Dietz J.;Dysart C. E.;Kellie S. M.;Franco-Sadud R. A.;Meier G.;Gaga M.;Holland T. L.;Bergin S. P.;Kheir F.;Landmeier M.;Lois M.;Nair G. B.;Patel H.;Reyes K.;Rodriguez-Cintron W.;Saito S.;Soni N. J.;Noda J.;Hinojosa C. I.;Levine S. M.;Angel L. F.;Anzueto A.;Whitlow K. S.;Hipskind J.;Sukhija K.;Totten V.;Wunderink R. G.;Shah R. D.;Mateyo K. J.;Noriega L.;Alvarado E.;Aman M.;Labra L.

2019

Abstract

Background and objective Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. Methods We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when >= 3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. Results Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. Conclusion This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.

Scheda breve

Scheda completa

Scheda completa (DC)

	Parole chiave
	
				Enterobacteriaceae; community-acquired pneumonia; multidrug-resistance; prevalence; risk factors
			
	Settori scientifico-disciplinari dell'articolo (sola visualizzazione)
	
				Settore MED/10 - Malattie dell'Apparato Respiratorio
			
	Data di pubblicazione
	
				2019
			
	Data ahead of print o data di stampa
	
				ago-2019
			
	Rivista in ANCE
	
				RESPIROLOGY
			
	DOI
	
				https://dx.doi.org/10.1111/resp.13663
			
	Tipologia
	
				Article (author)
			
	Appare nelle tipologie:
	
				01 - Articolo su periodico

File in questo prodotto:

File	Dimensione	Formato
Villafuerte_et_al-2019-Respirology.pdf accesso riservato Tipologia: Publisher's version/PDF Dimensione 1.6 MB Formato Adobe PDF Visualizza/Apri Richiedi una copia	1.6 MB	Adobe PDF	Visualizza/Apri Richiedi una copia

Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/673504

Citazioni

15

35

32

IRIS Institutional Research Information System - AIR Archivio Istituzionale della Ricerca