Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units

Yi, Jongyoun; Kim, Kye-Hyung

doi:10.4266/acc.2021.00409

Cited by 14 publications

(11 citation statements)

References 67 publications

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“…ICU patients are susceptible to acquiring HAIs due to underlying diseases, device use and previous antibiotic use. HAIs are associated with morbidity, mortality, and increased costs, and ICU patients have been reported to be at high risk of colonisation and infection caused by multidrug-resistant organisms [ 69 ]. Infections caused by antibiotic-resistant Klebsiella spp.…”

Section: Enterobacteralesmentioning

confidence: 99%

ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic

et al. 2023

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The ESKAPE group constitute a threat to public health, since these microorganisms are associated with severe infections in hospitals and have a direct relationship with high mortality rates. The presence of these bacteria in hospitals had a direct impact on the incidence of healthcare-associated coinfections in the SARS-CoV-2 pandemic. In recent years, these pathogens have shown resistance to multiple antibiotic families. The presence of high-risk clones within this group of bacteria contributes to the spread of resistance mechanisms worldwide. In the pandemic, these pathogens were implicated in coinfections in severely ill COVID-19 patients. The aim of this review is to describe the main microorganisms of the ESKAPE group involved in coinfections in COVID-19 patients, addressing mainly antimicrobial resistance mechanisms, epidemiology, and high-risk clones.

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Section: Enterobacteralesmentioning

confidence: 99%

ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic

et al. 2023

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“…The major risk factors of CRE acquisition include healthcare exposure and receiving broad-spectrum antibiotics, especially carbapenems [7] . The major risk factors for CRE colonization include underlying comorbid conditions, prior antibiotic exposure, prior hospitalization or residence in a long-term care facility, invasive devices, and extended stay in an intensive care unit (ICU) [8] .…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia

Shibabaw¹,

Sahle²,

Metaferia³

et al. 2023

IJID Regions

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“…CRE infections are difficult to treat because of extensive resistance patterns and the limited effective antimicrobial therapeutic options ( Magiorakos et al, 2017 ). Several factors, including prior antimicrobial exposure, longer ICU stay, or residence in a long-term care facility, contribute to the occurrence of CRE ( Yi and Kim, 2021 ). The presence of CRE colonization at ICU admission is associated with higher CRE infection-associated 30- and 90-day mortality risks ( McConville et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

“…In a surgical ICU, the financial costs accrued from CRE outbreaks in 3 years was approximately €1,300,000 ( Atchade et al, 2022 ). Therefore, decreasing the risk for CRE acquisition and ensuring active surveillance for the detection of CRE carriers is essential in the ICU ( Yi and Kim, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Gut microbiota alterations in critically Ill patients with carbapenem-resistant Enterobacteriaceae colonization: A clinical analysis

Baek

Kim

et al. 2023

Front. Microbiol.

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BackgroundCarbapenem-resistant Enterobacteriaceae (CRE) are an emerging concern for global health and are associated with high morbidity and mortality in critically ill patients. Risk factors for CRE acquisition include broad-spectrum antibiotic use and microbiota dysbiosis in critically ill patients. Therefore, we evaluated the alteration of the intestinal microbiota associated with CRE colonization in critically ill patients.MethodsFecal samples of 41 patients who were diagnosed with septic shock or respiratory failure were collected after their admission to the intensive care unit (ICU). The gut microbiota profile determined using 16S rRNA gene sequencing and quantitative measurement of fecal short-chain fatty acids were evaluated in CRE-positive (n = 9) and CRE negative (n = 32) patients. The analysis of bacterial metabolic abundance to identify an association between CRE acquisition and metabolic pathway was performed.ResultsCRE carriers showed a significantly increased proportion of the phyla Proteobacteria and decreased numbers of the phyla Bacteroidetes as compared to the CRE non-carriers. Linear discriminant analysis (LDA) with linear discriminant effect size showed that the genera Erwinia, Citrobacter, Klebsiella, Cronobacter, Kluyvera, Dysgomonas, Pantoea, and Alistipes had an upper 2 LDA score in CRE carriers. The alpha-diversity indices were significantly decreased in CRE carriers, and beta-diversity analysis demonstrated that the two groups were clustered significantly apart. Among short-chain fatty acids, the levels of isobutyric acid and valeric acid were significantly decreased in CRE carriers. Furthermore, the PICRUSt-predicted metabolic pathways revealed significant differences in five features, including ATP-binding cassette transporters, phosphotransferase systems, sphingolipid metabolism, other glycan degradation, and microbial metabolism, in diverse environments between the two groups.ConclusionCritically ill patients with CRE have a distinctive gut microbiota composition and community structure, altered short-chain fatty acid production and changes in the metabolic pathways. Further studies are needed to determine whether amino acids supplementation improves microbiota dysbiosis in patients with CRE.

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Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units

Cited by 14 publications

References 67 publications

ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic

ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic

Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia

Gut microbiota alterations in critically Ill patients with carbapenem-resistant Enterobacteriaceae colonization: A clinical analysis

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