Risk associated with a systematic search of extended-spectrum β-lactamase-producing Enterobacteriaceae.
We evaluated 74 children with previous fecal extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae colonization who were hospitalized and receiving a course of antibiotic therapy for suspected infection. Sixty-four patients (86.5%) received a carbapenem agent. Only 3 patients were infected with an ESBL-producing Enterobacteriaceae. Sixty-one (95%) initial antibiotic courses were considered excessive and required deescalation; however, deescalation was accomplished in only 38 patients (62%). This suggests the need for an ESBL control program to decrease carbapenem use and thereby limit carbapenem resistance in gram-negative bacilli.
Infectious Disease Department, Necker-Enfants-Malades Hospital, AP-HP, Université Paris-Descartes, Paris, France.
Roberta
R
Prinapori
Julie
J
Guinaud
Antoine
A
Khalil
Herve
H
Lecuyer
Dominique
D
Gendrel
Olivier
O
Lortholary
Xavier
X
Nassif
Claudio
C
Viscoli
Jean-Ralph
JR
Zahar
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015780:Carbapenems / Q000627:therapeutic use*; D002648:Child; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases