Impact of Previous Use of Antibiotics on Development of Resistance to Extended-Spectrum Cephalosporins in Patients with Enterobacter Bacteremia

Abstract

Sixty-seven cases of group B streptococcal bacteremia in adults were retrospectively reviewed during the period 1991-2000. Not one case occurred in pregnant women. The mean age of the patients was 57 years, and 67.2% were men. Of the 67 cases of illness, 25.4% were hospital acquired and 11.9% were polymicrobial. Common predisposing diseases included hepatic disease (55.2%), diabetes mellitus (28.4%), malignancy (20.9%), and cardiovascular diseases (17.9%). Primary bacteremia, peritonitis, bone and joint infections, and skin and soft tissue infections accounted for most presentations. Peritonitis was a more common presentation in patients with hepatic disease (P<0.001), whereas skin and soft tissue infection was more common in patients with nonhepatic disease (P=0.008). More patients with hepatic disease had polymicrobial bacteremia than did patients with nonhepatic disease (P=0.018). Death occurred in 9.8% of cases, and mortality did not differ between patients with hepatic disease and those with nonhepatic disease. Hepatic disease was found to be an important predisposing condition in adults with group B streptococcal bacteremia. However, mortality for patients with hepatic disease was similar to that for patients with nonhepatic disease.