Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceae in North-Eastern France and outcomes of infected patients

Muggeo, Anaëlle; Guillard, Thomas; Barbe, Coralie; Thierry, A; Bajolet, Odile; Vernet-Garnier, Véronique; Limelette, Anne; Brasme, Lucien; Champs, Christophe de

doi:10.1093/jac/dkw590

Cited by 17 publications

(6 citation statements)

References 30 publications

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“…The burden attributable to respiratory infections has been well-described in the literature; however, few studies have focused specifically on the impact of gram-negative respiratory C-NS infections in comparison with C-S infections, and there are no studies of which we are aware that have evaluated both clinical and economic outcomes and the resulting financial impact to the hospital. The in-hospital mortality rates reported here are broadly comparable to others in the literature, with previously reported rates ranging from 14.5% to 60.6% for C-NS isolates [14][15][16]23,24]. The highest mortality rate in this study (25.7%) was in patients with other conditions (a principal diagnosis other than bacterial pneumonia) who developed a concomitant respiratory infection during their hospital stay.…”

Section: Discussionsupporting

confidence: 85%

Attributable burden in patients with carbapenem-nonsusceptible gram-negative respiratory infections

Tabak

Sung

et al. 2020

PLoS ONE

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ObjectiveWe aimed to describe the clinical and economic burden attributable to carbapenem-nonsusceptible (C-NS) respiratory infections. MethodsThis retrospective matched cohort study assessed clinical and economic outcomes of adult patients (aged �18 years) who were admitted to one of 78 acute care hospitals in the United States with nonduplicate C-NS and carbapenem-susceptible (C-S) isolates from a respiratory source. A subset analysis of patients with principal diagnosis codes denoting bacterial pneumonia or other diagnoses was also conducted. Isolates were classified as communityor hospital-onset based on collection time. A generalized linear mixed model method was used to estimate the attributable burden for mortality, 30-day readmission, length of stay (LOS), cost, and net gain/loss (payment minus cost) using propensity score-matched C-NS versus C-S cohorts.

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Section: Discussionsupporting

confidence: 85%

Attributable burden in patients with carbapenem-nonsusceptible gram-negative respiratory infections

Tabak

Sung

et al. 2020

PLoS ONE

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“…In the present study, 5 of 15 LT recipients with CRO infections died, and all-cause mortality was 33.3%, consistent with the studies mentioned above. Previous exposure to carbapenems was considered to be predictive of CRO infection, through resistance selection or induction, which was also proved by the present study, since carbapenem exposure for C 3 days prior to infection was related to CRO infection [25].…”

Section: Discussionsupporting

confidence: 78%

Drug Resistance and Risk Factors for Acquisition of Gram-Negative Bacteria and Carbapenem-Resistant Organisms Among Liver Transplant Recipients

Long

Peng

et al. 2022

Infect Dis Ther

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Introduction: Infections caused by Gram-negative bacteria, in particular carbapenem-resistant organisms (CRO), pose a great threat to liver transplant (LT) recipients. Understanding the risk factors for Gram-negative and CRO infections and the drug resistance of corresponding bacteria will help guide the prevention and treatment of these infections.Methods: Data on the composition, distribution and drug resistance of Gram-negative bacteria and CRO among LT recipients were collected. The risk factors for Gram-negative and CRO infections were identified via univariate and multivariate analysis. Results: A total of 45 episodes of Gram-negative infection, including 20 episodes of CRO infection, occurred in 19.9% (27/136) of LT recipients. Klebsiella pneumoniae was the dominant pathogenic bacteria (14/45; 31.1%). The most common site of infection was the abdominal cavity/bile duct (11/27; 40.7%). Eleven (8.1%) patients died within 2 months after LT, and two deaths were related to Gram-negative infection. Gram-negative bacteria were relatively sensitive to tigecycline and polymyxin B, with resistance of 26.7 and 11.1%, respectively. CRO had lower resistance to ceftazidime/ avibactam (45.5%) and polymyxin B (10%). A univariate analysis showed that male sex, infection within 2 months prior to LT, duration of surgery C 400 min, reoperation, indwelling urethral catheter use C 3 days and elevated alanine aminotransferase on day 1 post-LT were associated with Gram-negative infection. Multivariate logistic regression analysis revealed that infection within 2 months prior to LT [odds ratio (OR) = 4.426, 95%CI: 1.634-11.99, P = 0.003], duration of surgery C 400 min

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“…The widespread use of carbapenems for treatment of community-onset infections should be avoided. There have been concerns about the emergence of carbapenem-resistant Enterobacteriaceae (CRE) 910. Furthermore, we do not currently have a highly reliable treatment option for CRE infections 11.…”

Section: Introductionmentioning

confidence: 99%

Clinical Prediction Score for Community-Onset Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Species

et al. 2019

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Background This study aimed to identify the predictors and build a prediction score for community-onset bloodstream infections (CO-BSIs) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella species. Methods All CO-BSIs caused by E. coli and Klebsiella species from 2012 to 2015 were grouped into derivation (BSIs from 2012 to 2014) and validation (BSIs in 2015) cohorts. A prediction score was built using the coefficients of the multivariate logistic regression model from the derivation cohort. Results The study included 886 CO-BSIs (594 and 292 in the derivation and validation cohorts, respectively). The independent predictors of CO-BSIs caused by ESBL-producing E. coli and Klebsiella species included: 1) identification of ESBL-producing microorganisms from any clinical culture within one year of admission, 2) beta-lactam or fluoroquinolone treatment within 30 days (with 2 or more courses within 90 days; with 1 course within 90 days), 3) hospitalization within one year, 4) the presence of an indwelling urinary catheter at the time of admission. The area under the curve (AUC) of the clinical prediction score was 0.72 (95% confidence interval [CI], 0.68–0.77). In the validation cohort, the AUC was 0.70 (95% CI, 0.63–0.77). Conclusions The results of this study suggest a simple and easy-to-use scoring system to predict CO-BSIs caused by ESBL-producing E. coli and Klebsiella species.

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Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceae in North-Eastern France and outcomes of infected patients

Cited by 17 publications

References 30 publications

Attributable burden in patients with carbapenem-nonsusceptible gram-negative respiratory infections

Attributable burden in patients with carbapenem-nonsusceptible gram-negative respiratory infections

Drug Resistance and Risk Factors for Acquisition of Gram-Negative Bacteria and Carbapenem-Resistant Organisms Among Liver Transplant Recipients

Clinical Prediction Score for Community-Onset Bloodstream Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Species

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