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Comparing the Outcomes of Patients With Carbapenemase-Producing and Non-Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae Bacteremia

Published on Feb 1, 2017in Clinical Infectious Diseases9.05
· DOI :10.1093/cid/ciw741
Pranita D. Tamma24
Estimated H-index: 24
(JHUSOM: Johns Hopkins University School of Medicine),
Katherine E. Goodman4
Estimated H-index: 4
(Johns Hopkins University)
+ 4 AuthorsPatricia J. Simner18
Estimated H-index: 18
(JHUSOM: Johns Hopkins University School of Medicine)
Abstract
Abstract Carbapenem-resistant Enterobacteriaceae (CRE) are associated with considerable mortality. As mechanisms of carbapenem resistance are heterogeneous, it is unclear if mortality differs based on resistance mechanisms. We sought to determine whether CRE resistance mechanism determination is prognostically informative. We conducted an observational study comparing 14-day mortality between patients with carbapenemase-producing (CP)-CRE compared with non-CP-CRE bacteremia. Clinical data were collected on all patients. A comprehensive DNA microarray-based assay was performed on all isolates to identify β-lactamase-encoding genes. There were 83 unique episodes of monomicrobial CRE bacteremia during the study period: 37 (45%) CP-CRE and 46 (55%) non-CP-CRE. The majority of CP-CRE isolates were bla KPC (92%), followed by bla NDM (5%) and bla OXA-48-type (3%). CP-CRE isolates were more likely to have meropenem minimum inhibitory concentrations (MICs) ≥16 µg/mL, while non-CP-CRE isolates were more likely to have meropenem MICs ≤1 µg/mL (P value
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  • References (25)
  • Citations (78)
References25
Newest
#1Pranita D. Tamma (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 24
#2Yanjie Huang (Johns Hopkins University)H-Index: 2
Last.Patricia J. Simner (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 18
view all 4 authors...
#1Katherine E. Goodman (Johns Hopkins University)H-Index: 4
#2Patricia J. Simner (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 18
Last.Aaron M. Milstone (Johns Hopkins University)H-Index: 29
view all 4 authors...
#1Yedidah Fraenkel-Wandel (Shaare Zedek Medical Center)H-Index: 2
#2David Raveh-Brawer (Shaare Zedek Medical Center)H-Index: 2
Last.Marc Victor Assous (Shaare Zedek Medical Center)H-Index: 12
view all 5 authors...
#1Nora Chea (CDC: Centers for Disease Control and Prevention)H-Index: 12
#2Sandra N. Bulens (CDC: Centers for Disease Control and Prevention)H-Index: 20
Last.Alexander J. Kallen (CDC: Centers for Disease Control and Prevention)H-Index: 33
view all 19 authors...
#1George L. Daikos (UoA: National and Kapodistrian University of Athens)H-Index: 37
#2Sophia Tsaousi (UoA: National and Kapodistrian University of Athens)H-Index: 1
Last.Athanasios Skoutelis (UoA: National and Kapodistrian University of Athens)H-Index: 21
view all 14 authors...
Cited By78
Newest
#1Hiroyuki Kitano (Hiroshima University)H-Index: 4
#2Jun Teishima (Hiroshima University)H-Index: 13
Last.Akio Matsubara (Hiroshima University)H-Index: 23
view all 6 authors...
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