Endemic extended-spectrum beta-lactamase-producing Klebsiella pneumoniae at an intensive care unit: risk factors for colonization and infection.

摘要: A prospective cohort study was undertaken to describe the epidemiology of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBLKp) acquisition at an intensive care unit (ICU) in a non-outbreak setting. Surveillance for ESBLKp colonization and infection performed patients admitted ICU from January, 2000, May, 2001. Screening intestinal done by culturing rectal swab specimens admission, 72 hr after admission weekly until discharge or detection ESBLKp. The incidence 5.8/1,000 patient-days (95%CI, 3.4-10.1), 1.7/1,000 0.7-4.2). Use vancomycin (OR 6.6; 95%CI, 1.73-25.28), amphotericin B 12.0; 1.79-80.51), metronidazole 5.3; 1.10-25.65), ciprofloxacin 0.1; 0.01-0.97) were independently associated with colonization. Previous 60.6; 56.33-578.73) infection. Each ICU-acquired isolate belonged different genotype ERIC-PCR pulsed-field gel electrophoresis (PFGE) had plasmid profile, suggesting that cross transmission not main source acquisition. Factors setting those previously reported during outbreaks. Intestinal confirmed as risk factor this pathogen.