Risk Factors for Emergence of Resistance to Broad-Spectrum Cephalosporins among Enterobacter spp

Author:

Kaye Keith S.1,Cosgrove Sara1,Harris Anthony2,Eliopoulos George M.1,Carmeli Yehuda1

Affiliation:

1. Division of Infectious Diseases and Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts,1and the

2. Division of Healthcare Outcomes, Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Maryland2

Abstract

ABSTRACT Among 477 patients with susceptible Enterobacter spp., 49 subsequently harbored third-generation cephalosporin-resistant Enterobacter spp. Broad-spectrum cephalosporins were independent risk factors for resistance (relative risk [OR] = 2.3, P = 0.01); quinolone therapy was protective (OR = 0.4, P = 0.03). There were trends toward decreased risk for resistance among patients receiving broad-spectrum cephalosporins and either aminoglycosides or imipenem. Of the patients receiving broad-spectrum cephalosporins, 19% developed resistance.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference12 articles.

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3. Cosgrove S. E. K. S. Kaye G. M. Eliopoulos and Y. Carmeli. Impact of emergence of third-generation cephalosporin resistance in Enterobacter species on patient outcomes: mortality length of stay and hospital cost. Arch. Intern. Med. in press.

4. Colonization with broad-spectrum cephalosporin-resistant gram-negative bacilli in intensive care units during a nonoutbreak period: prevalence, risk factors, and rate of infection.;D'Agata E. M.;Crit. Care Med.,1999

5. Infections with gram-negative bacilli in a cardiac surgery intensive care unit: the relative role of enterobacter.;Flynn D. M.;J. Hosp. Infect.,1988

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