Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain

Background Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA inf...

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Vydáno v:Infection Ročník 52; číslo 6; s. 2231 - 2240
Hlavní autoři: Salamanca-Rivera, Elena, Palacios-Baena, Zaira R., Cañada, Javier E., Moure, Zaira, Pérez-Vázquez, María, Calvo-Montes, Jorge, Martínez-Martínez, Luis, Cantón, Rafael, Ruiz Carrascoso, Guillermo, Pitart, Cristina, Navarro, Ferran, Bou, Germán, Mulet, Xavier, González-López, Juan José, Sivianes, Fran, Delgado-Valverde, Mercedes, Pascual, Álvaro, Oteo-Iglesias, Jesús, Rodríguez-Baño, Jesús
Médium: Journal Article
Jazyk:angličtina
Vydáno: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2024
Springer Nature B.V
Témata:
Adult
Aged
Aged, 80 and over
Antibiotics
Bacteremia
Bacterial Proteins - genetics
Bacterial Proteins - metabolism
beta-Lactamases - genetics
beta-Lactamases - metabolism
blood flow
Carbapenemase
cohort studies
Community-Acquired Infections - epidemiology
Community-Acquired Infections - microbiology
cross infection
Cross Infection - epidemiology
Cross Infection - microbiology
E coli
Epidemiology
Escherichia coli
Escherichia coli - genetics
Escherichia coli Infections - epidemiology
Escherichia coli Infections - microbiology
Family Medicine
Female
General Practice
Health care
Hospitals
Humans
Impact analysis
Infectious Diseases
Internal Medicine
Klebsiella
Klebsiella Infections - epidemiology
Klebsiella Infections - microbiology
Klebsiella Infections - mortality
Klebsiella pneumoniae
Klebsiella pneumoniae - enzymology
Klebsiella pneumoniae - genetics
Male
Medicine
Medicine & Public Health
Middle Aged
Mortality
Multivariate analysis
Nosocomial infection
Nosocomial infections
Patients
Prospective Studies
Spain
Spain - epidemiology
Urinary tract
Spain
Clinical features
KPC-3
Carbapenem resistant
OXA-48
Risk factors
Carbapenem resistant Enterobacterales
ISSN:0300-8126, 1439-0973, 1439-0973
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Shrnutí:Background Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21–13.19). Conclusions HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0300-8126
1439-0973
1439-0973
DOI:10.1007/s15010-024-02267-0