Risk factors for microbiologic failure in children with Enterobacter species bacteremia.

<h4>Background</h4>Enterobacter species are an important cause of healthcare-associated bloodstream infections (BSI) in children. Up to 19% of adult patients with Enterobacter BSI have recurrence of infection resistant to third-generation cephalosporins (3GCs) while on therapy with a 3GC...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Juri Boguniewicz, Paula A Revell, Michael E Scheurer, Kristina G Hulten, Debra L Palazzi
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/170df7f4e082459fba84f0bd441a4095
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:170df7f4e082459fba84f0bd441a4095
record_format	dspace
spelling	oai:doaj.org-article:170df7f4e082459fba84f0bd441a40952021-12-02T20:17:11ZRisk factors for microbiologic failure in children with Enterobacter species bacteremia.1932-620310.1371/journal.pone.0258114https://doaj.org/article/170df7f4e082459fba84f0bd441a40952021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258114https://doaj.org/toc/1932-6203<h4>Background</h4>Enterobacter species are an important cause of healthcare-associated bloodstream infections (BSI) in children. Up to 19% of adult patients with Enterobacter BSI have recurrence of infection resistant to third-generation cephalosporins (3GCs) while on therapy with a 3GC. Data are lacking regarding the incidence of and risk factors for recurrence of infection in children with Enterobacter BSI.<h4>Methods</h4>We conducted a retrospective case-control study of patients aged ≤21 years old admitted to Texas Children's Hospital from January 2012 through December 2018 with Enterobacter BSI. The primary outcome was microbiologic failure from 72 hours to 30 days after the initial BSI (cases). The secondary outcome was isolation of a 3GC non-susceptible Enterobacter sp. from a patient with an initial 3GC-susceptible isolate.<h4>Results</h4>Twelve patients (6.7%) had microbiologic failure compared to 167 controls without microbiologic failure. Of the 138 patients (77.1%) with an Enterobacter sp. isolate that was initially susceptible to 3GCs, 3 (2.2%) developed a subsequent infection with a non-susceptible isolate. Predictors of microbiologic failure were having an alternative primary site of infection besides bacteremia without a focus or an urinary tract infection (OR, 9.64; 95% CI, 1.77-52.31; P < 0.01) and inadequate source control (OR, 22.16; 95% CI, 5.26-93.36; P < 0.001).<h4>Conclusions</h4>Source of infection and adequacy of source control are important considerations in preventing microbiologic failure. In-vitro susceptibilities can be used to select an antibiotic regimen for the treatment of Enterobacter BSI in children.Juri BoguniewiczPaula A RevellMichael E ScheurerKristina G HultenDebra L PalazziPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258114 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Juri Boguniewicz Paula A Revell Michael E Scheurer Kristina G Hulten Debra L Palazzi Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
description	<h4>Background</h4>Enterobacter species are an important cause of healthcare-associated bloodstream infections (BSI) in children. Up to 19% of adult patients with Enterobacter BSI have recurrence of infection resistant to third-generation cephalosporins (3GCs) while on therapy with a 3GC. Data are lacking regarding the incidence of and risk factors for recurrence of infection in children with Enterobacter BSI.<h4>Methods</h4>We conducted a retrospective case-control study of patients aged ≤21 years old admitted to Texas Children's Hospital from January 2012 through December 2018 with Enterobacter BSI. The primary outcome was microbiologic failure from 72 hours to 30 days after the initial BSI (cases). The secondary outcome was isolation of a 3GC non-susceptible Enterobacter sp. from a patient with an initial 3GC-susceptible isolate.<h4>Results</h4>Twelve patients (6.7%) had microbiologic failure compared to 167 controls without microbiologic failure. Of the 138 patients (77.1%) with an Enterobacter sp. isolate that was initially susceptible to 3GCs, 3 (2.2%) developed a subsequent infection with a non-susceptible isolate. Predictors of microbiologic failure were having an alternative primary site of infection besides bacteremia without a focus or an urinary tract infection (OR, 9.64; 95% CI, 1.77-52.31; P < 0.01) and inadequate source control (OR, 22.16; 95% CI, 5.26-93.36; P < 0.001).<h4>Conclusions</h4>Source of infection and adequacy of source control are important considerations in preventing microbiologic failure. In-vitro susceptibilities can be used to select an antibiotic regimen for the treatment of Enterobacter BSI in children.
format	article
author	Juri Boguniewicz Paula A Revell Michael E Scheurer Kristina G Hulten Debra L Palazzi
author_facet	Juri Boguniewicz Paula A Revell Michael E Scheurer Kristina G Hulten Debra L Palazzi
author_sort	Juri Boguniewicz
title	Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
title_short	Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
title_full	Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
title_fullStr	Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
title_full_unstemmed	Risk factors for microbiologic failure in children with Enterobacter species bacteremia.
title_sort	risk factors for microbiologic failure in children with enterobacter species bacteremia.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/170df7f4e082459fba84f0bd441a4095
work_keys_str_mv	AT juriboguniewicz riskfactorsformicrobiologicfailureinchildrenwithenterobacterspeciesbacteremia AT paulaarevell riskfactorsformicrobiologicfailureinchildrenwithenterobacterspeciesbacteremia AT michaelescheurer riskfactorsformicrobiologicfailureinchildrenwithenterobacterspeciesbacteremia AT kristinaghulten riskfactorsformicrobiologicfailureinchildrenwithenterobacterspeciesbacteremia AT debralpalazzi riskfactorsformicrobiologicfailureinchildrenwithenterobacterspeciesbacteremia
_version_	1718374391776018432

Risk factors for microbiologic failure in children with Enterobacter species bacteremia.

Ejemplares similares