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[Enterobacter cloacae infections at the Regional Hospital in Tromsø]
B M Andersen1, S M Almdahl, D Sørlie
1Mikrobiologisk avdeling, Regionsykehuset i Tromsø.
Insights
Enterobacter cloacae infections led to significant mortality, particularly in critically ill patients. Restricting cephalosporin use reduced multidrug-resistant strains, highlighting the importance of antibiotic stewardship in hospitals.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Abstract:
Enterobacter cloacae was isolated from 69 patients hospitalized at the University Hospital of Tromsø, Norway, during a period of 18 months. The total lethality was 11.6% (8/69) and death occurred most often in patients with a serious underlying condition. Death due to septicaemia occurred in 4/10 patients. Multiple beta-lactam resistant strains were present in 15 patients and were associated with septicaemiae (7/10, p less than 0.0005). Cephalosporin treatment had been given to every third patient (24/69), and nearly half of them (10/24) were infected by multiple beta-lactam resistant E cloacae. E cloacae occurred mainly as a nosocomial infection, since more than 70% of all patients infected had been treated by an invasive procedure prior to isolation of the bacterium. A high number of E cloacae strains were from operation wounds, especially among patients at the Department of Surgery (22/30). At this Department, the total number of E cloacae, and especially the number of multiresistant strains, was markedly reduced during restricted use of cefalosporins.