Risk factors and clinical features of infections caused by plasmid-mediated AmpC beta-lactamase-producing Enterobacteriaceae
- Authors
- Park, Yoon Soo; Yoo, Sunmi; Seo, Mi-Ran; Kim, Jin Yong; Cho, Yong Kyun; Pai, Hyunjoo
- Issue Date
- Jul-2009
- Publisher
- ELSEVIER
- Keywords
- Plasmid-mediated; AmpC beta-lactamase; Risk factors; Clinical features
- Citation
- INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, v.34, no.1, pp.38 - 43
- Indexed
- SCIE
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
- Volume
- 34
- Number
- 1
- Start Page
- 38
- End Page
- 43
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/176558
- DOI
- 10.1016/j.ijantimicag.2009.01.009
- ISSN
- 0924-8579
- Abstract
- A case-control study was performed with the objective of analysing risk factors and clinical features of infections caused by plasmid-mediated AmpC beta-lactamase (plasmid AmpC)-producing Enterobacteriaceae. All patients infected with plasmid AmpC-producing Enterobacteriaceae in two tertiary care hospitals from December 2006 to August 2007 were included. Plasmid AmpC enzymes were characterised by isoelectric focusing, enzyme inhibition assay and enzyme-specific polymerase chain reaction. A total of 30 patients (20 with Klebsiella pneumoniae and 10 with Escherichia coli) were recruited prospectively. CMY-2 and DHA-1 were the most common plasmid AmpC in E. coli and K. pneumoniae, respectively. An independent risk factor for infection with plasmid AmpC-producing Enterobacteriaceae was the use of an oxyimino-cephalosporin within 1 month of plasmid AmpC infection [adjusted odds ratio (aOR), 10.8, 95% confidence interval (CI), 1.6-75.4; P = 0.016], with the use of a urinary catheter showing borderline significance (aOR, 6, 95% CI 0.93-38.4; P = 0.06). An independent risk factor for treatment failure at 72 h was infection due to plasmid AmpC-producing Enterobacteriaceae (aOR, 9.78, 95% CI 1.34-71.17; P = 0.02). These results suggest that infections caused by plasmid AmpC-producing isolates significantly increase treatment failure at 72 h and that prior use of an oxyimino-cephalosporin is a risk factor for infections caused by plasmid AmpC-producing Enterobacteriaceae.
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