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Clinical and Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Klebsiella spp.: A Systematic Review and Meta-Analyses

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  • Tirza C Hendrik
  • Anne F Voor in ‘t holt
  • Margreet C Vos

Abstract

Healthcare-related infections caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella spp. are of major concern. To control transmission, deep understanding of the transmission mechanisms is needed. This systematic review aimed to identify risk factors and sources, clonal relatedness using molecular techniques, and the most effective control strategies for ESBL-producing Klebsiella spp. A systematic search of PubMed, Embase, and Outbreak Database was performed. We identified 2771 articles from November 25th, 1960 until April 7th, 2014 of which 148 were included in the systematic review and 23 in a random-effects meta-analysis study. The random-effects meta-analyses showed that underlying disease or condition (odds ratio [OR] = 6.25; 95% confidence interval [CI] = 2.85 to 13.66) generated the highest pooled estimate. ESBL-producing Klebsiella spp. were spread through person-to-person contact and via sources in the environment; we identified both monoclonal and polyclonal presence. Multi-faceted interventions are needed to prevent transmission of ESBL-producing Klebsiella spp.

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  • Tirza C Hendrik & Anne F Voor in ‘t holt & Margreet C Vos, 2015. "Clinical and Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Klebsiella spp.: A Systematic Review and Meta-Analyses," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-23, October.
    • Handle: RePEc:plo:pone00:0140754
    DOI: 10.1371/journal.pone.0140754
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    Cited by:

    1. Chidozie Declan Iwu & Anthony Ifeanyi Okoh, 2019. "Preharvest Transmission Routes of Fresh Produce Associated Bacterial Pathogens with Outbreak Potentials: A Review," IJERPH, MDPI, vol. 16(22), pages 1-34, November.
    2. Wibke Wetzker & Yvonne Pfeifer & Solvy Wolke & Andrea Haselbeck & Rasmus Leistner & Axel Kola & Petra Gastmeier & Florian Salm, 2019. "Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli Isolated from Flies in the Urban Center of Berlin, Germany," IJERPH, MDPI, vol. 16(9), pages 1-9, April.

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