臺大醫院;臺大醫院-內科部;臺大醫院-檢驗醫學部;臺大醫學院;臺大醫學院-內科;臺大醫學院-檢驗醫學科;Lee, Nan-YaoNan-YaoLeeLee, Hsin-ChunHsin-ChunLeeHuang, Wei-HanWei-HanHuangTsui, Ko-ChungKo-ChungTsuiCHIA-MING CHANGLee, Ching-ChiChing-ChiLeeChen, Po-LinPo-LinChenWu, Chi-JungChi-JungWuPO-REN HSUEHKo, Wen-ChienWen-ChienKo2018-09-102018-09-102012http://www.scopus.com/inward/record.url?eid=2-s2.0-84859817596&partnerID=MN8TOARShttp://scholars.lib.ntu.edu.tw/handle/123456789/368948Background: The purpose of this study is to delineate clinical characteristics of urosepsis caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae (ESBL-EK) in different clinical settings, with an emphasis on community-acquired infections. Methods: A retrospective study was conducted at two medical centers in Taiwan. From May 2002 to August 2007, clinical data of adults with urosepsis caused by ESBL-EK were collected. Patients were categorized into three groups according to the place of acquisition. Baseline characteristics, microbiological data and clinical outcomes were compared. Results: Ninety-three cases of ESBL-EK urosepsis were included. Their mean age was 69.4 years, and 48.4% were men. Eleven (11.8%), 41 (44.1%), and 41 (44.1%) patients were categorized as having community-acquired, healthcare-associated, and hospital-acquired infections, respectively. Cases of ESBL-EK urosepsis from different settings shared similar characteristics in terms of age, gender, comorbidity and resistance profiles of bacterial strains. Of the bacterial isolates, 75% and 38.7% were resistant to fluoroquinolones and aminoglycosides, respectively. Cases of community-acquired urosepsis had a lower disease severity than those acquired in healthcare facilities or hospitals. Of note, there was no case fatality in 11 cases of community-acquired urosepsis and, in contrast, a crude mortality rate of 41.5% was found among adults with hospital-acquired urosepsis (p < 0.001). Conclusion: A limited number of adults with community-acquired urosepsis caused by ESBL-EK in the present study had a favorable outcome. Nonetheless, clinicians should be cautious of the emergence of urinary tract infections caused by ESBL-producers in the community setting. ? 2011.108 bytestext/html[SDGs]SDG3aminoglycoside antibiotic agent; extended spectrum beta lactamase; quinoline derived antiinfective agent; adult; aged; antibiotic resistance; article; bacterium isolate; clinical feature; disease severity; Escherichia coli; fatality; female; health care facility; hospital; hospital infection; human; Klebsiella pneumoniae; major clinical study; male; mortality; nonhuman; outcome assessment; retrospective study; urinary tract infection; urosepsis; Adult; Aged; Aged, 80 and over; beta-Lactamases; Community-Acquired Infections; Escherichia coli; Escherichia coli Infections; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Middle Aged; Prevalence; Retrospective Studies; Sepsis; Taiwan; Urinary Tract Infectionsjournal article10.1016/j.jmii.2011.09.029