Abstract
BACKGROUND
Extended-spectrum beta-lactamase (ESBL) producing pathogens are a growing health threat due to their resistance to most of the commonly used antimicrobial agents.
AIM
In this paper, we aimed to assess the prevalence of those pathogens among patients who received care in the home parenteral antimicrobial therapy program. We also aimed to examine the burden of those pathogens on the home health care services and discuss the options to minimize this burden.
METHODS
This retrospective cohort study was conducted in the Adult Home Health Care Service at King Abdulaziz Medical City in Riyadh, Saudi Arabia. We studied all patients referring to the home health care parenteral antimicrobial program in the period from January 1, 2019 to December 31, 2021. Patients' data were retrieved from their electronic medical records. We classified patients as a patient with ESBL infection and a patient with a non-ESBL infection based on their cultures.
RESULTS
A total of 253 patients, of whom 144 (56.9%) were females, were accepted into the home parenteral antimicrobial therapy during the specified period. Of these, 121 (47.8%) were treated with an infection with ESBL-producing bacteria. Escherichia coli (92.76.0%) and Klebsiella pneumoniae (23.19.0%) were the most commonly isolated ESBL pathogens. Female gender, a previous history of UTI or ESBL infection, cognitive impairment and BPH in men were all associated with a higher rate of ESBL infections (P<0.05). Infection caused by ESBL-producing pathogen was not associated with a significantly increased rate of complications, readmission or mortality (P≥0.05).
CONCLUSION
Almost half of the patients treated in the home parenteral antimicrobial program are infected with an ESBL producing pathogens. However, we did not find any significant increase in adverse clinical outcomes associated with those infections in our sample. The burden on the HHC services that comes with these infections is mostly related to the limited choices of antimicrobials and to the high rate of recurrence.