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.
Table 5
Clinical characteristics and outcomes of patients treated with a cephalosporin as an appropriate definitive antimicrobial treatment under the revised CLSI guidelines in ESBL-producing or nonproducing E. coli and Klebsiella spp. bacteremia.
Variables
Patients with bacteremia caused by
Non-UTI Patients with bacteremia caused by
Enterobacteriaceae
Enterobacteriaceae
ESBL-producing
Non-ESBL-producing
value
ESBL-producing
Non-ESBL-producing
-value
= 10, (%)
= 20, (%)
= 7, (%)
= 14, (%)
Age (years), mean ± SD
64.261 ± 12.976
65.15 ± 11.47
0.849
60.34 ± 12.603
63.70 ± 10.265
0.519
Male
7 (70.00)
12 (60.00)
0.702
6 (85.7)
10 (71.4)
0.624
Organism
E. coli
7 (70.00)
14 (70.00)
1.000
5 (71.4)
8 (57.1)
0.192
K. pneumonia
1 (10.00)
6 (30.00)
0.372
1 (14.3)
6 (42.9)
K. oxytoca
2 (20.00)
0 (0.00)
0.103
1 (14.3)
0 (0.00)
Hospital acquired
5 (50.00)
7 (35.00)
0.461
4 (57.1)
5 (35.7)
0.397
Community acquired
5 (50.00)
13 (65.00)
3 (42.9)
9 (64.3)
Underlying disease
Malignancy
Solid
5 (50.00)
10 (50.00)
1.000
4 (57.1)
9 (64.3)
1.000
Hematologic
2 (20.00)
1 (5.00)
0.251
2 (28.6)
1 (7.1)
0.247
Transplantation
Solid
0 (0.00)
2 (10.00)
0.540
0 (0.0)
2 (14.3)
0.533
Hematopoietic stem cell
0 (0.00)
0 (0.00)
0 (0.0)
0 (0.0)
Diabetes
2 (20.00)
7 (35.00)
0.675
0 (0.0)
5 (35.7)
0.123
Cardiovascular disease
2 (20.00)
8 (40.00)
0.420
0 (0.0)
4 (28.6)
0.255
Chronic lung disease
0 (0.00)
1 (5.00)
1.000
0 (0.00)
1 (7.1)
1.000
Chronic renal disease
2 (20.00)
1 (5.00)
0.251
1 (14.3)
1 (7.1)
1.000
Chronic liver disease
0 (0.00)
1 (5.00)
1.000
0 (0.00)
1 (7.1)
1.000
Source of infection
Urinary tract infection
3 (30.00)
6 (30.00)
1.000
Pancreatobiliary infection
5 (50.00)
10 (50.00)
1.000
5 (71.4)
10 (71.4)
1.000
Primary bacteremia
2 (20.00)
4 (20.00)
1.000
2 (28.6)
4 (28.6)
1.000
SOFA score, mean ± SD
4.300 ± 3.653
4.300 ± 3.556
1.000
5.71 ± 3.450
5.71 ± 3.315
1.000
Antimicrobials
Cefpiramide
4 (40.0)
5 (25.0)
1.000
3 (42.9)
5 (35.7)
1.000
Cefotaxime
1 (10.0)
3 (15.0)
1.000
1 (14.3)
2 (14.3)
1.000
Ceftriaxone
5 (50.0)
12 (60.0)
1.000
3 (42.9)
7 (50.0)
1.000
Clinical outcomes
Treatment failure after 72 hr
3 (30.00)
2 (10.00)
0.300
3 (42.9)
0 (0.0)
0.026
28-day mortality
1 (10.00)
1 (5.00)
1.000
1 (14.3)
1 (7.1)
1.000
CLSI, Clinical and Laboratory Standards Institute; ESBL, extended-spectrum beta lactamase; E. coli, Escherichia coli; HIV, human immunodeficiency syndrome; ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment; SD, standard deviation; Tx., treatment.