Multivariate analysis of risk factors for ESBL and AmpC producing Escherichia coli and Klebsiella pneumoniae at a Tertiary Care Hospital in Karnataka: A case control study
Journal Title: Indian Journal of Microbiology Research - Year 2018, Vol 5, Issue 1
Abstract
Introduction Extended spectrum betalactamase ESBL and AmpC producing organisms pose unique challenges to clinical microbiologists clinicians infection control professionalsThe objective of the present study was to analyze the risk factors that will help in identifying those at risk of acquiring infection by ESBL andor AmpC producing organisms thereby making appropriate changes in the choice of antimicrobial therapy and minimizing treatment failuresMaterials and Methods Risk factors were evaluated using a retrospective Case control design 100 patientsnbspwith infections due to ESBL and or AmpC producing Ecoli or K pneumoniae were employed as cases These were matched with 100 patients with non ESBL non AmpC producing organisms Controls Univariate and Multivariate logistic regression analysis was performed to identify variables associated with becoming a caseResults Out of the total 100 cases Ecoli 61 61 was the predominant ESBL andor AmpC producer followed by Klebsiella pneumonia 39 39 In the multivariate analysis we found that duration of hospital stay for more than 5 days OR016 P0 stay in ICU OR298 P002 and prior treatment with antibiotics OR281 P0003 were statistically significant risk factors associated with acquisition of ESBLAmpC producers We also found invasive procedures like usage of urinary catheter OR334 Plt0005 central venous catheter OR335 P0018 intravenous catheter OR738 Plt0005 and other surgical procedures OR314 P00002 contributed significantly to the spread of ESBLAmpC producersConclusion ESBL and AmpC producing strains were found to show higher rates of resistance to various class of antibiotics when compared to non ESBL and AmpC producers Knowledge on risk factors of infection helps physicians in framing appropriate empirical antibiotic policiesKeywords AmpC resistance Case control Extended spectrum beta lactamases Risk factors
Authors and Affiliations
Aaftab G. P, Asha B Patil, Shobha Medegar
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