From the FDA Drug Label
Adult Patients: Urinary Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Serratia marcescens, Proteus mirabilis, Providencia rettgeri, Morganella morganii, Citrobacter diversus, Citrobacter freundii Lower Respiratory Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis Skin and Skin Structure Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Bone and Joint Infections caused by Enterobacter cloacae, Serratia marcescens Complicated Intra-Abdominal Infections (used in combination with metronidazole) caused by Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains) Typhoid Fever (Enteric Fever) caused by Salmonella typhi Gram-negative bacteria Citrobacter freundii Enterobacter cloacae Escherichia coli Haemophilus influenzae Klebsiella oxytoca Klebsiella pneumoniae Gram-negative bacteria Acinetobacter baumannii* Aeromonas hydrophila Citrobacter koseri Enterobacter aerogenes Haemophilus influenzae (ampicillin-resistant) Haemophilus parainfluenzae Pasteurella multocida Serratia marcescens Stenotrophomonas maltophilia
The different kinds of infections caused by the family Enterobacteriaceae include:
- Urinary Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis, Providencia rettgeri, Morganella morganii, Citrobacter diversus, Citrobacter freundii
- Lower Respiratory Tract Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis
- Skin and Skin Structure Infections caused by Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Proteus mirabilis
- Bone and Joint Infections caused by Enterobacter cloacae, Serratia marcescens
- Complicated Intra-Abdominal Infections caused by Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae
- Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains)
- Typhoid Fever (Enteric Fever) caused by Salmonella typhi 1 2
From the Research
The family Enterobacteriaceae causes a wide range of infections in humans, including urinary tract infections (UTIs), pneumonia, bloodstream infections, wound infections, and gastrointestinal infections, with UTIs being the most common, typically caused by Escherichia coli, as reported in a recent study 3.
Types of Infections
- Urinary tract infections (UTIs): The most common type of infection, typically caused by Escherichia coli, presenting with dysuria, frequency, and sometimes fever, with a high clinical cure rate of 97.4% when treated with ceftolozane/tazobactam, as shown in a pooled analysis of Phase 3 clinical trials 4.
- Pneumonia: Can occur particularly in hospitalized patients, often due to Klebsiella pneumoniae, causing cough, fever, and respiratory distress.
- Bloodstream infections (bacteremia): Can result from any Enterobacteriaceae, leading to sepsis with symptoms like high fever, hypotension, and organ dysfunction.
- Wound infections: Occur when these bacteria contaminate surgical sites or traumatic injuries.
- Gastrointestinal infections: Caused by pathogens like Salmonella, Shigella, and pathogenic E. coli strains, resulting in diarrhea, abdominal pain, and sometimes bloody stool.
Treatment and Antibiotic Resistance
Treatment typically involves antibiotics such as third-generation cephalosporins, fluoroquinolones, or carbapenems, though increasing antibiotic resistance, particularly extended-spectrum beta-lactamase (ESBL) production and carbapenem resistance, complicates management, with a study showing that piperacillin-tazobactam may be an effective alternative to carbapenems for treatment of nonbacteremic UTIs due to ESBL-producing Enterobacteriaceae 5. Infection severity, patient factors, and local resistance patterns should guide antibiotic selection, with treatment durations ranging from 3-5 days for uncomplicated UTIs to 7-14 days for more severe infections, as discussed in a review of piperacillin/tazobactam use in the treatment of bacterial infections 6. A recent study highlighted the increasing incidence of UTIs caused by multidrug-resistant (MDR) bacteria, resulting in a significant increase in the spread of antibiotic resistance and the economic burden of these infections 3. Another study found that nearly half of patients with ESBL-producing Enterobacteriaceae had no identifiable health care-associated risk factor, and discordant empiric therapy was common 7.