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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

The impact of production of extended-spectrum β-lactamases on the 28-day mortality rate of patients with Proteus mirabilis bacteremia in Korea

Authors: Jin Young Ahn, Hea Won Ann, Yongduk Jeon, Mi Young Ahn, Dong Hyun Oh, Yong Chan Kim, Eun Jin Kim, Je Eun Song, In Young Jung, Moo Hyun Kim, Wooyoung Jeong, Nam Su Ku, Su Jin Jeong, Jun Yong Choi, Dongeun Yong, Young Goo Song, June Myung Kim

Published in: BMC Infectious Diseases | Issue 1/2017

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Abstract

Background

The incidence of Proteus mirabilis antimicrobial resistance, especially that mediated by extended-spectrum β-lactamases (ESBLs), has increased. We investigated the impact of ESBL production on the mortality of patients with P. mirabilis bacteremia in Korea.

Methods

Patients diagnosed with P. mirabilis bacteremia between November 2005 and December 2013 at a 2000-bed tertiary care center in South Korea were included in this study. Phenotypic and molecular analyses were performed to assess ESBL expression. Characteristics and treatment outcomes were investigated among ESBL-producing and non-ESBL-producing P. mirabilis bacteremia groups. A multivariate analysis of 28-day mortality rates was performed to evaluate the independent impact of ESBLs.

Results

Among 62 P. mirabilis isolates from 62 patients, 14 expressed ESBLs (CTX-M, 2; TEM, 5; both, 6; other, 1), and the 28-day mortality rate of the 62 patients was 17.74%. No clinical factor was significantly associated with ESBL production. The 28-day mortality rate in the ESBL-producing group was significantly higher than that in the non-ESBL-producing group (50% vs. 8.3%, p = 0.001). A multivariate analysis showed that ESBL production (odds ratio [OR], 11.53, 95% confidence interval [CI], 2.11–63.05, p = 0.005) was independently associated with the 28-day mortality rate in patients with P. mirabilis bacteremia.

Conclusions

ESBL production is significantly associated with mortality in patients with bacteremia caused by P. mirabilis. Rapid detection of ESBL expression and prompt appropriate antimicrobial therapy are required to reduce mortality caused by P. mirabilis bacteremia.
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Metadata
Title
The impact of production of extended-spectrum β-lactamases on the 28-day mortality rate of patients with Proteus mirabilis bacteremia in Korea
Authors
Jin Young Ahn
Hea Won Ann
Yongduk Jeon
Mi Young Ahn
Dong Hyun Oh
Yong Chan Kim
Eun Jin Kim
Je Eun Song
In Young Jung
Moo Hyun Kim
Wooyoung Jeong
Nam Su Ku
Su Jin Jeong
Jun Yong Choi
Dongeun Yong
Young Goo Song
June Myung Kim
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-017-2431-8

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