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Master Thesis

Gravité clinique et biologique initiale des bactériémies à entérobactéries productrices de bêtalactamase à spectre élargi (E-BLSE) aux urgences : comparaison avec les bactériémies à entérobatéries non BLSE par une étude cas-témoins

Abstract : INTRODUCTION : Extended-spectrum ß-lactamase-producing enterobacteriaceae infections (E-ESBL) are increasing in frequency. E-ESBL bacteremia is a serious form of these infections. It is suggested that their mortality is greater than that of non-ESBL enterobacteriaceae bacteremia. Our objective was to determine if the initial clinical and laboratory severity of E-ESBL bacteremia differed from that of non-ESBL enterobacteriaceae bacteremia. POPULATION AND METHODS : We conducted a retrospective case-control study. The cases were adults patients with E-ESBL bacteremia when they entered the Emergency Department (ED) of the CHU Grenoble Alpes between the beginning of 2010 and the end of 2016. The controls were the adult patients presenting non-ESBL-producing enterobacteriaceae bacteremia when entering the ED in 2016. Each case was matched to two controls. The matching criteria were age, Charlson Comorbidity Index and the bacterium involved. RESULTS : 63 cases were matched with 126 controls. There was no difference in terms of severity between the two groups : the median SOFA score was 4 [2-5] for the cases and 3 [2-5] for the controls (p=0,171); the proportion of sepsis and septic shock was identical, the Pitt Bacteremia median score was measured at 1 [0-2] in the both groups (p=0,131). DISCUSSION AND CONCLUSION : The initial clinical and laboratory severity of E-ESBL bacteremia is similar to that of non-ESBL enterobacteriaceae bacteremia. This suggests that the multidrug resistance of enterobacteriaceae is not associated with a decrease in their virulence.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01813150
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Submitted on : Tuesday, June 12, 2018 - 9:43:52 AM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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Véronique Fontaine. Gravité clinique et biologique initiale des bactériémies à entérobactéries productrices de bêtalactamase à spectre élargi (E-BLSE) aux urgences : comparaison avec les bactériémies à entérobatéries non BLSE par une étude cas-témoins. Médecine humaine et pathologie. 2018. ⟨dumas-01813150⟩

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