Bloodstream Infections by Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae in Children: Epidemiology and Clinical Outcome

• DOI: 10.1128/aac.46.5.1481-1491.2002
• Publication Date: 2002-07-27T10:09:01Z
• Authors: Yun-Kyung Kim; Hyunjoo Pai; Hoan-Jong Lee; Su-Eun Park; Eun-Hwa Choi; Jungmin Kim; Je-Hak Kim; Eui-Chong Kim
• Keywords: Bacteremia; Case fatality rate

ABSTRACT To determine the epidemiologic features and clinical outcomes of bloodstream infections caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli Klebsiella pneumoniae isolates, cases bacteremia these organisms in children were analyzed retrospectively. Among 157 blood isolates recovered from 1993 to 1998 at Seoul National University Children's Hospital, prevalence ESBL production was 17.9% among E. 52.9% K. isolates. The commonest ESBLs SHV-2a TEM-52. A novel ESBL, TEM-88, identified. Pulsed-field gel electrophoresis analysis ESBL-producing showed extensive diversity clonality. medical records 142 episodes reviewed. risk factors for infection with prior hospitalization, use oxyimino-cephalosporins, admission an intensive care unit within previous month. There no difference severity between patients infected strains (the group) those ESBL-nonproducing non-ESBL time presentation. However, overall fatality rate group significantly higher than that group: 12 45 (26.7%) versus 5 87 (5.7%) ( P = 0.001). In a subset treated cephalosporins or without aminoglycoside, favorable response rates 3rd day (6 17 33 51; 0.035), 5th 36 50; < 0.05), end therapy (9 47 conclusion, infecting has significant impact on course survival pediatric .