title: [Bacteraemia due to extended-spectrum beta-lactamases (ESBL) and other beta-lactamases (ampC and carbapenemase) producing Enterobacteriaceae: association with health-care and cancer].
abstract: BACKGROUND
  Bloodstream infections due to multire-sistant Enterobacteriaceae are a major matter of concern nowadays. The present study evaluated the impact of these infections in our area.
  
  
  METHODS
  Prospective observational study of a cohort of patients with bacteraemia due to extended-spectrum beta-lactamases (ESBL) and other beta-lactamases producing organisms among hospitalized patients in Cruces Hospital for 2 years. We conducted a descriptive analysis, a subgroup analysis (cancer vs. non-cancer patients) and a mortality analysis.
  
  
  RESULTS
  During the study period, 3409 episodes of bacteraemia were diagnosed, of which 124 (3.6%) were ESBL and other beta-lactamases producing Enterobacteriaceae. 40.3% of the cases were nosocomial, 15.3% community acquired and 44.4% were health-care associated. 44.4% of the cohort had cancer as underlying disease. The most commonly isolated organism was E. coli (83% of cases), regardless of the source of infection. 58.1% of patients received inadequate empirical therapy. 7 day-mortality was 10.5% and 30 day-mortality was 21.8%. None of the analyzed variables showed association with 7 and 14 day-mortality, but the presence of solid cancer (p= 0.032) and advanced HIV infection (p = 0.027), were significantly associated with higher 30 day-mortality.
  
  
  CONCLUSIONS
  More than half of bacteraemia episodes affected outpatients and most of them were health-care associated episodes. Even though more than half of the patients received inadequate empirical treatment, this was not related to higher mortality. We only found an association between 30 day-mortality and the presence of underlying solid malignancy or advanced HIV infection.
authors.affiliation: Miriam García Gómez, Unidad de Enfermedades Infecciosas. Hospital Universitario Cruces. Plaza de Cruces s/n, 48903, Barakaldo. Bizkaia, Sapin. miriam.garciagomez@osakidetza.net.
authors.forename: Miriam
authors.initials: M
authors.lastname: García-Gómez
authors.forename: Laura
authors.initials: L
authors.lastname: Guío
authors.forename: José Luis
authors.initials: JL
authors.lastname: Hernández
authors.forename: Begoña
authors.initials: B
authors.lastname: Vilar
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Pijoán
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Montejo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D001426:Bacterial Proteins / Q000378:metabolism*; D015331:Cohort Studies; D003428:Cross Infection / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000187:drug effects; D004756:Enterobacteriaceae Infections / Q000209:etiology / Q000382:microbiology* / Q000401:mortality; D004927:Escherichia coli Infections / Q000382:microbiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011446:Prospective Studies; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases; C063912:carbapenemase