Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study
AIMS: Aminoglycoside resistance is frequently detected in extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE), questioning the appropriateness of aminoglycosides as empiric therapy in patients with suspected ESBL-PE infections. Therefore, we aimed to evaluate the frequency...
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2024-10-01
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| Series: | Swiss Medical Weekly |
| Online Access: | https://smw.ch/index.php/smw/article/view/3904 |
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| author | Isabelle Vock Lisandra Aguilar-Bultet Nina Khanna Adrian Egli Elisabeth Wehrle-Wieland Pranita D. Tamma Sarah Tschudin Sutter |
| author_facet | Isabelle Vock Lisandra Aguilar-Bultet Nina Khanna Adrian Egli Elisabeth Wehrle-Wieland Pranita D. Tamma Sarah Tschudin Sutter |
| author_sort | Isabelle Vock |
| collection | DOAJ |
| description |
AIMS: Aminoglycoside resistance is frequently detected in extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE), questioning the appropriateness of aminoglycosides as empiric therapy in patients with suspected ESBL-PE infections. Therefore, we aimed to evaluate the frequency of aminoglycoside resistance in patients harbouring ESBL-PE and identify patient-related risk factors associated with aminoglycoside resistance to facilitate early detection of at-risk patients.
METHODS: This retrospective single-centre cohort study included hospitalised patients aged ≥18 years with an ESBL-PE-positive sample between January 2016 and December 2018. Aminoglycoside resistance was defined according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints for Enterobacterales for the current year of testing.
RESULTS: Five hundred forty-four patients met the eligibility criteria, of which 240 (44.1%) harboured aminoglycoside-resistant ESBL strains. Identification of ESBL-Klebsiella pneumoniae was significantly associated with aminoglycoside resistance (odds ratio [OR] = 2.64, 95% confidence interval [CI] = 1.65–4.21, p <0.001) and an international travel history within the past 12 months was marginally associated with aminoglycoside resistance (OR = 1.51, 95% CI = 0.95–2.42, p = 0.084).
CONCLUSIONS: In a low ESBL endemicity setting, aminoglycoside resistance in patients harbouring ESBL-PE is common, especially ESBL-K. pneumoniae, and needs to be considered in clinicians’ decision-making regarding empiric therapy regimens.
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| format | Article |
| id | doaj-art-a34fbbfd98b7481fb2252e19f5259525 |
| institution | OA Journals |
| issn | 1424-3997 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj-art-a34fbbfd98b7481fb2252e19f52595252025-08-20T02:18:10ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972024-10-011541010.57187/s.3904Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort studyIsabelle VockLisandra Aguilar-BultetNina KhannaAdrian EgliElisabeth Wehrle-WielandPranita D. TammaSarah Tschudin Sutter0University Hospital Basel, Switzerland AIMS: Aminoglycoside resistance is frequently detected in extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales (ESBL-PE), questioning the appropriateness of aminoglycosides as empiric therapy in patients with suspected ESBL-PE infections. Therefore, we aimed to evaluate the frequency of aminoglycoside resistance in patients harbouring ESBL-PE and identify patient-related risk factors associated with aminoglycoside resistance to facilitate early detection of at-risk patients. METHODS: This retrospective single-centre cohort study included hospitalised patients aged ≥18 years with an ESBL-PE-positive sample between January 2016 and December 2018. Aminoglycoside resistance was defined according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) clinical breakpoints for Enterobacterales for the current year of testing. RESULTS: Five hundred forty-four patients met the eligibility criteria, of which 240 (44.1%) harboured aminoglycoside-resistant ESBL strains. Identification of ESBL-Klebsiella pneumoniae was significantly associated with aminoglycoside resistance (odds ratio [OR] = 2.64, 95% confidence interval [CI] = 1.65–4.21, p <0.001) and an international travel history within the past 12 months was marginally associated with aminoglycoside resistance (OR = 1.51, 95% CI = 0.95–2.42, p = 0.084). CONCLUSIONS: In a low ESBL endemicity setting, aminoglycoside resistance in patients harbouring ESBL-PE is common, especially ESBL-K. pneumoniae, and needs to be considered in clinicians’ decision-making regarding empiric therapy regimens. https://smw.ch/index.php/smw/article/view/3904 |
| spellingShingle | Isabelle Vock Lisandra Aguilar-Bultet Nina Khanna Adrian Egli Elisabeth Wehrle-Wieland Pranita D. Tamma Sarah Tschudin Sutter Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study Swiss Medical Weekly |
| title | Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study |
| title_full | Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study |
| title_fullStr | Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study |
| title_full_unstemmed | Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study |
| title_short | Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study |
| title_sort | quantifying aminoglycoside resistance in extended spectrum beta lactamase esbl producing enterobacterales clinical isolates a retrospective cohort study |
| url | https://smw.ch/index.php/smw/article/view/3904 |
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