Please cite this article in press as: Neulier C, et al. Enterobacteriaceae bacteremia: Risk factors for ESBLPE. Med Mal Infect (2013), http://dx.doi.org/10.1016/j.medmal.2013.11.003 ARTICLE IN PRESS +Model MEDMAL-3462; No. of Pages 7 Disponible en ligne sur ScienceDirect www.sciencedirect.com Médecine et maladies infectieuses xxx (2013) xxx–xxx Original article Enterobacteriaceae bacteremia: Risk factors for ESBLPE Bactériémie à entérobactérie : facteurs de risque de EBLSE C. Neulier a , G. Birgand a,∗,b,c , É. Ruppé d , L. Armand-Lefèvre d , I. Lolom a , Y. Yazdanpanah b,c,e , J.-C. Lucet a,b,c , A. Andremont d a Infection Control Unit, UHLIN, hôpital Bichat-Claude-Bernard, AP–HP, 46, rue Henri-Huchard, 75877 Paris cedex 18, France b IAME, UMR 1137, université Paris-Diderot, Sorbonne Paris-Cité, 75018 Paris, France c IAME, UMR 1137, INSERM, 75018 Paris, France d Bacteriology laboratory, Bichat-Claude-Bernard Hospital, 75018 Paris, France e Service de maladies infectieuses et tropicales, hôpital Bichat-Claude-Bernard, AP–HP, 75018 Paris, France Received 23 May 2013; received in revised form 16 September 2013; accepted 8 November 2013 Abstract Objectives. – The increasing prevalence of extended spectrum beta-lactamase producing enterobacteriaceae (ESBLPE) requires defining the use of carbapenems in first intention. We analyzed the associations between enterobacteriaceae bacteremia (EbBact) and ESBLPE carriage during 10 years in a 950-bed teaching hospital. Methods. – We analyzed a 10-year (July 2001 to June 2011) prospective collection of bacteremia cases including 2 databases: (1) EbBact and (2) a computerized database of patients carrying EBLSE. Only one episode of EbBact was analyzed per patient and hospital stay. Factors associated with ESBLPE bacteremia were assessed by univariate and multivariate logistic regression analysis. Results. – Overall, 2355 cases of EbBact were identified, among which 135 (5.7%) were ESBLPE (2001–05: 1.4%, 2006–09: 7.6%, 2010–11: 14.2%). ESBLPE bacteremia was observed in 52 of the 88 (59%) patients carrying ESBLPE and in 83/2267 (3.7%) patients not known to be colonized with ESBLPE. Factors associated with ESBLPE bacteremia in patients not known to be colonized were: female gender (ORa = 0.56, CI95% [0.34–0.91]), hospitalization in the ICU (ORa = 2.51 [1.27–5.05]) or medical/surgical wards (ORa = 1.83 [1.04–3.38]), the period (2006–09, ORa = 4.08 [2.21–8.16]; 2010–11, ORa = 8.17 [4.14–17.06] compared to 2001–05), and history of EbBact (ORa = 2.29 [0.97–4.79]). Conclusion. – In case of EbBact, patients known to be colonized with ESBLPE present with ESBLPE bacteremia in more than half of the cases, requiring carbapenems as empirical antibiotic treatment. The global prevalence of ESBLPE among patients presenting with EbBact not known to be colonized with ESBLPE was 3.7%. © 2013 Elsevier Masson SAS. All rights reserved. Keywords: Bacteremia; Extended spectrum beta-lactamase producing enterobacteriaceae; Carbapenems Résumé Introduction. – L’augmentation de la prévalence des entérobactéries productrices de bêtalactamase à spectre étendu (EBLSE) nécessite de définir la place des carbapénèmes en première intention. Nous avons analysé les associations entre bactériémie à entérobactérie (BactEb) et portage d’EBLSE en 10 ans dans un CHU de 950 lits. Méthodes. – Analyse rétrospective d’un recueil prospectif entre juillet 2001 et juin 2011 avec fusion de deux bases : (1) BactEb et (2) base informatisée des patients (Pts) porteurs d’EBLSE. Un seul épisode de BactEb par Pt et par hospitalisation était conservé. Les facteurs associés à une Bact à EBLSE ont été recherchés en analyse univariée, puis multivariée. Résultats. – Au total, 2355 BactEb ont été identifiées, dont 135 (5,7 %) à EBLSE (2001–05 : 1,4 %, 2006–09 : 7,6 %, 2010–11 : 14,2 %). Une Bact à EBLSE était identifiée chez 52 des 88 Pts (59 %) connus porteurs d’EBLSE et 83/2267 (3,7 %) des Pts non connus porteurs. Les facteurs ∗ Corresponding author. E-mail address: gbirgand@gmail.com (G. Birgand). 0399-077X/$ – see front matter © 2013 Elsevier Masson SAS. All rights reserved. http://dx.doi.org/10.1016/j.medmal.2013.11.003