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Quantifying aminoglycoside resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales clinical isolates: a retrospective cohort study. | LitMetric

AI Article Synopsis

  • Aminoglycoside resistance is prevalent in patients with extended-spectrum-beta-lactamase (ESBL)-producing Enterobacterales, impacting the choice of empirical treatment for infections.
  • A study of 544 hospitalized patients found that 44.1% had aminoglycoside-resistant ESBL strains, particularly linked to ESBL-Klebsiella pneumoniae and recent international travel.
  • The findings highlight the necessity for clinicians to factor in the high rates of resistance when deciding on antibiotic therapy for suspected ESBL-PE infections, especially in settings with low ESBL prevalence.

Article Abstract

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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Source
http://dx.doi.org/10.57187/s.3904DOI Listing

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