Klebsiella ESBL bacteremia-mortality and risk factors

background: extended spectrum β-lactamase (esbl)-producing bacteria have become recognized as a problem in south america. the aim of this study was to evaluate risk factors and mortality rate in bacteremia caused by esbl-producing klebsiella pneumoniae in a brazilian hospital. methods: a three-year retrospective cohort study with 104 cases of k. pneumoniae bacteremia (61 esbl and 43 non-esbl). several clinical and laboratory variables were evaluated. the outcome of interest was 30-day mortality. the adequate treatment was evaluated according to antibiotic susceptibility. results: multivariable analysis showed that central venous catheter and mechanical ventilation were independent risk factors for esbl. the duration of hospitalization before the bacteremia was not a risk factor. mortality was similar in esbl and non-esbl and inadequate therapy was not shown to be a risk factor. conclusion: esbl-producing klebsiella bacteremia can occur early, suggesting that a carbapenem should be included in the initial empirical therapy for bacteremia in patients under mechanical ventilation and/or central venous catheter in our institution.