Please use this identifier to cite or link to this item:
https://doi.org/10.1371/journal.pone.0034254
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dc.title | Risk factors, molecular epidemiology and outcomes of ertapenem-resistant, carbapenem-susceptible enterobacteriaceae: A case-case-control study | |
dc.contributor.author | Teo J. | |
dc.contributor.author | Cai Y. | |
dc.contributor.author | Tang S. | |
dc.contributor.author | Lee W. | |
dc.contributor.author | Tan T.Y. | |
dc.contributor.author | Tan T.T. | |
dc.contributor.author | Kwa A.L.-H. | |
dc.date.accessioned | 2019-11-11T06:41:12Z | |
dc.date.available | 2019-11-11T06:41:12Z | |
dc.date.issued | 2012 | |
dc.identifier.citation | Teo J., Cai Y., Tang S., Lee W., Tan T.Y., Tan T.T., Kwa A.L.-H. (2012). Risk factors, molecular epidemiology and outcomes of ertapenem-resistant, carbapenem-susceptible enterobacteriaceae: A case-case-control study. PLoS ONE 7 (3) : e34254. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0034254 | |
dc.identifier.issn | 19326203 | |
dc.identifier.uri | https://scholarbank.nus.edu.sg/handle/10635/161993 | |
dc.description.abstract | Background: Increasing prevalence of ertapenem-resistant, carbapenem-susceptible Enterobacteriaceae (ERE) in Singapore presents a major therapeutic problem. Our objective was to determine risk factors associated with the acquisition of ERE in hospitalized patients; to assess associated patient outcomes; and to describe the molecular characteristics of ERE. Methods: A retrospective case-case-control study was conducted in 2009 at a tertiary care hospital. Hospitalized patients with ERE and those with ertapenem-sensitive Enterobacteriaceae (ESE) were compared with a common control group consisting of patients with no prior gram-negative infections. Risk factors analyzed included demographics; co-morbidities; instrumentation and antibiotic exposures. Two parallel multivariate logistic regression models were performed to identify independent variables associated with ERE and ESE acquisition respectively. Clinical outcomes were compared between ERE and ESE patients. Results: Twenty-nine ERE cases, 29 ESE cases and 87 controls were analyzed. Multivariate logistic regression showed that previous hospitalization (Odds ratio [OR], 10.40; 95% confidence interval [CI], 2.19-49.20) and duration of fluoroquinolones exposure (OR, 1.18 per day increase; 95% CI, 1.05-1.34) were unique independent predictors for acquiring ERE. Duration of 4 th-generation cephalosporin exposure was found to predict for ESE acquisition (OR, 1.63 per day increase; 95% CI, 1.05-2.54). In-hospital mortality rates and clinical response rates were significantly different between ERE and ESE groups, however ERE infection was not a predictor of mortality. ERE isolates were clonally distinct. Ertapenem resistance was likely to be mediated by the presence of extended-spectrum ?-lactamases or plasmid-borne AmpC in combination with impermeability due to porin loss and/or efflux pumps. Conclusion: Prior hospitalization and duration of fluoroquinolone treatment were predictors of ERE acquisition. ERE infections were associated with higher mortality rates and poorer clinical response rates when compared to ESE infections. © 2012 Teo et al. | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.source | Unpaywall 20191101 | |
dc.subject | amikacin | |
dc.subject | aminoglycoside | |
dc.subject | amoxicillin plus clavulanic acid | |
dc.subject | antibiotic agent | |
dc.subject | beta lactamase AmpC | |
dc.subject | carbapenem | |
dc.subject | cefepime | |
dc.subject | ceftriaxone | |
dc.subject | cephalosporin | |
dc.subject | ciprofloxacin | |
dc.subject | ertapenem | |
dc.subject | extended spectrum beta lactamase | |
dc.subject | gentamicin | |
dc.subject | penicillin G | |
dc.subject | piperacillin plus tazobactam | |
dc.subject | porin | |
dc.subject | antiinfective agent | |
dc.subject | beta lactam | |
dc.subject | carbapenem derivative | |
dc.subject | ertapenem | |
dc.subject | adult | |
dc.subject | aged | |
dc.subject | antibiotic resistance | |
dc.subject | antibiotic sensitivity | |
dc.subject | article | |
dc.subject | bacterium isolate | |
dc.subject | carbapenem susceptible Enterobacteriaceae | |
dc.subject | case control study | |
dc.subject | clonal variation | |
dc.subject | comorbidity | |
dc.subject | controlled study | |
dc.subject | demography | |
dc.subject | drug exposure | |
dc.subject | drug response | |
dc.subject | Enterobacteriaceae | |
dc.subject | Enterobacteriaceae infection | |
dc.subject | ertapenem resistant Enterobacteriaceae | |
dc.subject | female | |
dc.subject | hospital patient | |
dc.subject | hospitalization | |
dc.subject | human | |
dc.subject | independent variable | |
dc.subject | instrumentation | |
dc.subject | major clinical study | |
dc.subject | male | |
dc.subject | molecular epidemiology | |
dc.subject | mortality | |
dc.subject | multivariate logistic regression analysis | |
dc.subject | outcome assessment | |
dc.subject | retrospective study | |
dc.subject | risk factor | |
dc.subject | Singapore | |
dc.subject | tertiary health care | |
dc.subject | treatment duration | |
dc.subject | adolescent | |
dc.subject | cross infection | |
dc.subject | drug effect | |
dc.subject | Enterobacteriaceae infection | |
dc.subject | growth, development and aging | |
dc.subject | microbiology | |
dc.subject | middle aged | |
dc.subject | multidrug resistance | |
dc.subject | multivariate analysis | |
dc.subject | Singapore | |
dc.subject | statistical model | |
dc.subject | treatment outcome | |
dc.subject | Enterobacteriaceae | |
dc.subject | Negibacteria | |
dc.subject | Adolescent | |
dc.subject | Adult | |
dc.subject | Aged | |
dc.subject | Aged, 80 and over | |
dc.subject | Anti-Bacterial Agents | |
dc.subject | beta-Lactams | |
dc.subject | Carbapenems | |
dc.subject | Case-Control Studies | |
dc.subject | Cross Infection | |
dc.subject | Drug Resistance, Microbial | |
dc.subject | Drug Resistance, Multiple, Bacterial | |
dc.subject | Enterobacteriaceae | |
dc.subject | Enterobacteriaceae Infections | |
dc.subject | Female | |
dc.subject | Humans | |
dc.subject | Logistic Models | |
dc.subject | Male | |
dc.subject | Middle Aged | |
dc.subject | Molecular Epidemiology | |
dc.subject | Multivariate Analysis | |
dc.subject | Risk Factors | |
dc.subject | Singapore | |
dc.subject | Treatment Outcome | |
dc.subject | Young Adult | |
dc.type | Article | |
dc.contributor.department | DUKE-NUS MEDICAL SCHOOL | |
dc.contributor.department | NUSHS PROJECT | |
dc.description.doi | 10.1371/journal.pone.0034254 | |
dc.description.sourcetitle | PLoS ONE | |
dc.description.volume | 7 | |
dc.description.issue | 3 | |
dc.description.page | e34254 | |
dc.published.state | Published | |
Appears in Collections: | Staff Publications Elements |
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