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Carbapenem-resistant Enterobacterales (CRE) are classified as either carbapenemase-producing CRE (CP-CRE) or non-carbapenemase-producing CRE (non-CP-CRE) based on their mechanism of carbapenem resistance. Few studies have compared outcomes associated with each type of infection. We attempted to determine if either CRE subset is associated with increased mortality. We performed a retrospective observational study to collect demographic, clinical and outcomes data to compare patients with CP-CRE and non-CP-CRE bacteremia. Of 146 cases analyzed, 88/146 (60%) were CP-CRE and 58/146 (40%) were non-CP-CRE. Patients with CP-CRE bacteremia were less likely to receive active empiric or targeted antibiotic therapy. Non-CP-CRE bacteremia was associated with a 2.4 times higher hazard of death at 30 days after bacteremia onset compared to CP-CRE (HR, 2.4; 95% CI, 1.2, 4.6). Patients with non-CP-CRE bacteremia had a higher hazard of death at 30 days after bacteremia onset compared to those with CP-CRE bacteremia.
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http://dx.doi.org/10.1016/j.diagmicrobio.2021.115505 | DOI Listing |
Antibiotics (Basel)
June 2025
Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea.
Carbapenem-resistant (CRE) and carbapenem-resistant (CRPA) are challenging multidrug-resistant pathogens. This study evaluated the in vitro susceptibility of CRE and CRPA blood isolates from Korea to novel β-lactam/β-lactamase inhibitor combinations: ceftolozane/tazobactam (C/T), ceftazidime/avibactam (CZA), imipenem/cilastatin/relebactam (IMR), and meropenem/vaborbactam (MEV). Blood isolates of CRE ( = 55) and CRPA ( = 65) collected between September 2017 and September 2022 in a Korean tertiary hospital were included.
View Article and Find Full Text PDFAntimicrob Agents Chemother
August 2024
Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University, Jerusalem, Israel.
Non-carbapenemase-producing carbapenem-resistant (non-CP CRE) may be associated with a grave outcome. The common underlying mechanism is beta-lactamases and mutations in outer membrane porins. We report a case of a deep-seated infection caused by ST395 not amenable to source control, involving recurrent bloodstream infection, resulting in selection of carbapenem resistance under therapy.
View Article and Find Full Text PDFSci Rep
January 2024
Department of Anesthesiology and Pain Medicine, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University, 77 Sakju-ro, Chuncheon, 24253, Republic of Korea.
The spread of carbapenem-resistant Enterobacterales (CRE) poses a public health threat worldwide. We aimed to compare the mortality rates between the carbapenemase-producing (CP) and non-CP CRE bacteremia. We conducted a retrospective cohort study in patients with CRE bacteremia after propensity score (PS) matching.
View Article and Find Full Text PDFMicroorganisms
April 2023
Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang 10380, Republic of Korea.
Background: Bloodstream infection (BSI) caused by carbapenem-resistant (CRE) significantly influences patient morbidity and mortality. We aimed to identify the characteristics, outcomes, and risk factors of mortality in adult patients with CRE bacteremia and elucidate the differences between carbapenemase-producing (CP)-CRE BSI and non-CP-CRE BSI.
Methods: This retrospective study included 147 patients who developed CRE BSI between January 2016 and January 2019 at a large tertiary care hospital in South Korea.
mSystems
October 2022
Department of Infectious Diseases and Infection Control, The University of Texas MD Anderson Cancer Centergrid.240145.6, Houston, Texas, USA.
Noncarbapenemase-producing carbapenem-resistant (non-CP-CRE) are increasingly recognized as important contributors to prevalent carbapenem-resistant (CRE) infections. However, there is limited understanding of mechanisms underlying non-CP-CRE causing invasive disease. Long- and short-read whole-genome sequencing was used to elucidate carbapenem nonsusceptibility determinants in bloodstream isolates at MD Anderson Cancer Center in Houston, Texas.
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