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Prevalence and risk factors for Enterobacteriaceae in patients hospitalized with community‐acquired pneumonia
Author(s) -
Villafuerte David,
Aliberti Stefano,
Soni Nilam J.,
Faverio Paola,
Marcos Pedro J.,
Wunderink Richard G.,
Rodriguez Alejandro,
Sibila Oriol,
Sanz Francisco,
MartinLoeches Ignacio,
Menzella Francesco,
Reyes Luis F.,
Jankovic Mateja,
Spielmanns Marc,
Restrepo Marcos I.
Publication year - 2020
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.13663
Subject(s) - medicine , underweight , pneumonia , klebsiella pneumoniae , klebsiella pneumonia , body mass index , multiple drug resistance , cohort , pediatrics , antibiotics , staphylococcus aureus , microbiology and biotechnology , overweight , escherichia coli , biochemistry , chemistry , biology , bacteria , gene , genetics
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.