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Clinical usefulness of the 2010 clinical and laboratory standards institute revised breakpoints for cephalosporin use in the treatment of bacteremia caused by Escherichia coli or Klebsiella spp

 Nam Su Ku  ;  Hae-Sun Chung  ;  Jun Yong Choi  ;  Dongeun Yong  ;  Kyungwon Lee  ;  June Myung Kim  ;  Yunsop Chong 
 BIOMED RESEARCH INTERNATIONAL, Vol.2015 : 831074, 2015 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use* ; Bacteremia/drug therapy* ; Bacteremia/metabolism ; Bacteremia/microbiology ; Case-Control Studies ; Cephalosporins/therapeutic use* ; Escherichia coli/drug effects* ; Escherichia coli/metabolism ; Escherichia coli Infections/drug therapy ; Escherichia coli Infections/metabolism ; Escherichia coli Infections/microbiology ; Female ; Humans ; Klebsiella/drug effects* ; Klebsiella/metabolism ; Klebsiella Infections/drug therapy ; Klebsiella Infections/metabolism ; Klebsiella Infections/microbiology ; Male ; Middle Aged ; Retrospective Studies ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/metabolism ; Urinary Tract Infections/microbiology ; Young Adult ; beta-Lactamases/metabolism
We investigated the clinical usefulness of the revised 2010 Clinical and Laboratory Standards Institute (CLSI) breakpoints for Escherichia coli and Klebsiella spp. Of 2,623 patients with bacteremia caused by E. coli or Klebsiella spp., 573 who had been treated appropriately with cephalosporin based on the CLSI 2009 guidelines were enrolled. There were no differences in the rates of treatment failure or mortality between the appropriately and inappropriately treated groups according to the CLSI 2010 guidelines. Additionally, in the matched case-control analysis, the treatment failure rate was higher in bacteremic patients with extended-spectrum β-lactamase- (ESBL-) producing but cephalosporin-susceptible organisms than in those with ESBL-nonproducing isolates when patients with urinary tract infections were excluded (44% and 0%, resp., P = 0.026). In patients with bacteremia caused by E. coli or Klebsiella spp., the revised CLSI 2010 guidelines did not lead to poorer outcomes. However, ESBL production appeared to be associated with poor clinical outcomes in patients with bacteremia from sources other than the urinary tract.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, June Myung(김준명)
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Chong, Yun Sop(정윤섭)
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
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