Journal
FRONTIERS IN PHARMACOLOGY
Volume 12, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2021.716324
Keywords
mortality; carbapenemase-producing Klebsiella pneumoniae; carbapenemase-producing Enterobacteriales; multilocus sequence typing; molecular epidemiology
Categories
Funding
- Natural Science Foundation of Chognqing, China [cstc2020jcyj-msxmX0519]
- Science and Technology Research Program of the Chongqing Municipal Education Commission [KJ1500235, KJ1702022]
- Medical Research Program of the Chongqing Health and Family Planning Commission [2018MSXM009, 2016MSXM001]
Ask authors/readers for more resources
In Chongqing, China, the study revealed that CRE infections were associated with high mortality rates and poor outcomes, with CPE patients more likely to exhibit antibiotic resistance. Independent predictors for CPE infection were ICU admission and hepatobiliary system diseases. Although there was no significant difference in desirability of outcome ranking (DOOR) outcomes between the two groups, CPE patients had prolonged ICU stays.
Aim: We aim to depict the clinicoepidemiological and molecular information of carbapenem-resistant Enterobacteriales (CRE) in Chongqing, China. Methods: We performed a prospective, observational cohort study, recruiting inpatients diagnosed with CRE infections from June 1, 2018, to December 31, 2019. We carried out strain identification and molecular characterization of CRE. eBURST analysis was conducted to assess the relationships among the different isolates on the basis of their sequence types (STs) and associated epidemiological data using PHYLOViZ. Clinical parameters were compared between the carbapenemase-producing Enterobacteriales (CPE) and non-CPE group. Findings: 128 unique CRE isolates from 128 patients were collected during the study period: 69 (53.9%) CPE and 59 (46.1%) non-CPE. The majority of CPE isolates were bla(KPC-2) (56.5%), followed by bla(NDM) (39.1%) and bla(IMP) (5.8%). Klebsiella pneumoniae carbapenemase (KPC)-producing clonal group 11 Klebsiella pneumoniae (K. pneumoniae) was the most common CPE. Antibiotic resistance was more frequent in the CPE group than in the non-CPE group. Independent predictors for CPE infection were ICU admission and hepatobiliary system diseases. Although, there was no significant difference in desirability of outcome ranking (DOOR) outcomes between the two groups. At 30 days after index culture, 35 (27.3% ) of these patients had died. Conclusion: CRE infections were related to high mortality and poor outcomes, regardless of CRE subgroups. CPE were associated with prolonged ICU stays and had different clinical and microbiological characteristics than non-CPE. The identification of CPE/non-CPE and CRE resistance mechanisms is essential for better guidance of the clinical administration of patients with CRE infections.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available