Abstract
Background: To examine the clinical, demographic, and microbiologic characteristics of new rectal carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) carriers vs. those with a clinical infection, hospitalized at Padeh-Poriya Medical Center between 2014 and 2017 and to examine the susceptibility profiles of isolates from clinical infections.Methods: In this retrospective, chart analysis, demographic and clinical data were collected from medical charts of 175 adult patients with either new- onset carbapenemase-producing Enterobacterales (CPE) carriage or clinical CPE infection. Collected data included age, ethnic group, place of residence, hospitalizations in the past 90 days, and 30-day mortality. Microbiological analyses considered bacterial genus, molecular resistance mechanism and antibiotic susceptibility.Results: A significantly higher percentage (42.4%) of CPE carriers were long-term care facility residents, and had been recently hospitalized (56.3%), as compared to patients with clinical CPE infection (29.2 and 45.9%, respectively). Additionally, we noted a high (58.3%) acquision of CPE in our hospital. The most common bacterial isolate was K. pneumoniae and the most common resistance mechanism was Klebsiella pneumoniae (K. pneumoniae) carbapenemases (KPC). High susceptibility rates to amikacin and chloramphenicol were also noted.Conclusions: This study reaffirmed the importance of CPE screening and infection control measures. The observed antibiotic susceptibility profile suggests amikacin and chloramphenicol as potential treatments for CPE infection.
Highlights
Antibiotic resistance is one of the most significant challenges of twenty-first century medicine
To identify patient characteristics that may contribute to the development of clinical carbapenemase producers (CPE) infection and shed light on the effectiveness of the current prevention control strategies, this study reviewed the clinical and demographic profiles of patients who had a CPE carrier diagnosis or a clinical infection with CPE, and hospitalized in a small hospital in northeastern Israel, between 2014 and 2017
Of the 12,984 CPE tests performed on samples collected for screening or clinical diagnostic purposes from patients hospitalized in the medical center between 2014 and 2017, 175 (1.34%) were found positive
Summary
Antibiotic resistance is one of the most significant challenges of twenty-first century medicine. Carbapenem-resistant Enterobacterales (CRE) are of particular importance due to their diverse and extensive resistance, frequently even to extended-spectrum antibiotics [2]. CPE infections can include urinary tract infection (UTI), intra-abdominal infections, pneumonia (especially in ventilated patients), sepsis, skin and soft tissue infections, and surgical site infections. They are associated with a 3 to 6-times higher mortality rate as compared to non-CP CRE infections [1, 5], and possess a higher potential to spread to other patients [6]. Demographic, and microbiologic characteristics of new rectal carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) carriers vs. those with a clinical infection, hospitalized at Padeh-Poriya Medical Center between 2014 and 2017 and to examine the susceptibility profiles of isolates from clinical infections
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