Background
The worldwide spread of extended-spectrum-beta-lactamase (ESBL) producing bacteria
has affected health care. ESBL confers resistance to the majority of beta-lactam antibiotics.
Materials and Methods
We intended to quantify the rates of rectal ESBL-positive and negative patients that
eventually developed fever and urinary tract infection (UTI). All rectal ESBL-positive
patients were to be initially treated with the conventional antibiotics that have
anti-ESBL activity (amikacin or ertapenem), while ESBL-negative patients were given
ceftriaxone.
Results
Most patients were rectal ESBL-positive (60.7%). Fever was in 51% patients; 67.8%
of them developed signs and symptoms of UTI. Most patients with UTI were urinary ESBL-positive
(79%), most rectal ESBL-negative patients were urinary ESBL-negative (75%), (χ2 = 18.5, df = 1, P < .001). Overall mortality was higher in the febrile group (39, 34.8%) versus the
afebrile (1, 0.9%) (χ2 = 42, df = 1, P < .001). The mortality rate in the febrile group was significantly higher in the
rectal ESBL-positive patients (χ2 = 7.5, df = 1, P = .006).
Discussion
The direct correlation of rectal ESBL-positive and negative and respectively urinary
ESBL-positive and negative patients' advocate for the use of antibiotics with anti-ESBL
activity as an empiric treatment of rectal ESBL-positive patients with suspected UTI.
Conclusion
In our opinion, it is worthwhile to identify rectal ESBL-positivity on hospital admission.
Key Words
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Article Info
Publication History
Published online: June 01, 2018
Footnotes
Funding: The study did not have specific funding.
Conflicts of interest: The authors declare that they have no conflicts of interest.
Ethics approval: The study was approved by the institutional ethics committee.
Informed consent: For this type of study, formal consent is not required.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
