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Risk factors for 28-day mortality in elderly patients with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae bacteremia

Authors
 Nam Su Ku  ;  Yong Chan Kim  ;  Min Hyung Kim  ;  Je Eun Song  ;  Dong Hyun Oh  ;  Jin Young Ahn  ;  Sun Bean Kim  ;  Hye-won Kim  ;  Su Jin Jeong  ;  Sang Hoon Han  ;  Chang Oh Kim  ;  Young Goo Song  ;  June Myung Kim  ;  Jun Yong Choi 
Citation
 ARCHIVES OF GERONTOLOGY AND GERIATRICS, Vol.58(1) : 105-109, 2014 
Journal Title
ARCHIVES OF GERONTOLOGY AND GERIATRICS
ISSN
 0167-4943 
Issue Date
2014
MeSH
Age Factors ; Aged ; Aged, 80 and over ; Bacteremia/microbiology ; Bacteremia/mortality* ; Escherichia coli/enzymology* ; Escherichia coli/isolation & purification ; Escherichia coli Infections/microbiology ; Escherichia coli Infections/mortality* ; Female ; Follow-Up Studies ; Geriatric Assessment/methods* ; Humans ; Klebsiella Infections/microbiology ; Klebsiella Infections/mortality* ; Klebsiella pneumoniae/enzymology* ; Klebsiella pneumoniae/isolation & purification ; Male ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Rate/trends ; Time Factors ; beta-Lactamases/secretion*
Keywords
ESBL ; Elderly patients ; Gram-negative bacteremia ; Mortality ; Risk factor
Abstract
Gram-negative bacteremia is common in elderly patients and, compared with younger patients, mortality rates in bacteremic elderly patients are high. ESBL-producing organisms were one of the most important risk factors associated with mortality. In addition, older age is one of risk factors for colonization or infection with ESBL-producing organisms. We conducted a retrospective cohort study to evaluate risk factors of all-cause 28-day mortality in elderly patients with ESBL-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) bacteremia. Patients aged 65 years or older, who had one or more blood cultures positive for E. coli and K. pneumoniae and who were hospitalized between January 2006 and December 2010 at a tertiary-care teaching hospital, were included. 191 bacteremic elderly patients were eligible for the study. The all-cause 28-day mortality rate was 24.6% (47/191). In multivariate analysis, prior antimicrobial therapy (p = 0.014) and an elevated SOFA score (p < 0.001) were independent risk factors for increased mortality, while urinary tract infection (UTI) was an independent determinant for non-mortality (p = 0.011). In the current study, prior antimicrobial therapy within 30 days, an elevated SOFA score and nonurinary source of infection were significantly associated with adverse outcomes in elderly patients with ESBL-producing gram-negative bacteremia.
Full Text
http://www.sciencedirect.com/science/article/pii/S016749431300109X
DOI
10.1016/j.archger.2013.07.002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Min Hyung(김민형)
Kim, Sun Bean(김선빈)
Kim, Yong Chan(김용찬)
Kim, June Myung(김준명)
Kim, Chang Oh(김창오) ORCID logo https://orcid.org/0000-0002-0773-5443
Kim, Hye Won(김혜원)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Song, Je Eun(송제은)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Oh, Dong Hyun(오동현)
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97928
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