ScholarLink (思领科)
错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

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

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年5月4日

查看全文
  • Elena Salamanca-Rivera,
  • Zaira R. Palacios-Baena,
  • Javier E. Cañada,
  • Zaira Moure,
  • María Pérez-Vázquez,
  • Jorge Calvo-Montes,
  • Luis Martínez-Martínez,
  • Rafael Cantón,
  • Guillermo Ruiz Carrascoso,
  • Cristina Pitart,
  • Ferran Navarro,
  • Germán Bou,
  • Xavier Mulet,
  • Juan José González-López,
  • Fran Sivianes,
  • Mercedes Delgado-Valverde,
  • Álvaro Pascual,
  • Jesús Oteo-Iglesias,
  • Jesús Rodríguez-Baño,
  • Mariela Martínez Ramírez,
  • M. Pilar Ortega Lafont,
  • Emilia Cercenado,
  • Cristobal del Rosario,
  • Jose Luis Perez Arellano,
  • María Lecuona,
  • Luis López-Urrutia Lorente,
  • José Leiva,
  • José Luis del Pozo,
  • Salvador Giner,
  • Juan Frasquet,
  • Lidia Garcia Agudo,
  • Soledad Illescas,
  • Pedro de la Iglesia,
  • Rosario Sánchez Benito,
  • Eugenio Garduño,
  • Ma Isabel Fernández Natal,
  • Marta Arias,
  • Mar Olga Pérez Moreno,
  • Ana Isabel López-Calleja,
  • José Manuel Azcona,
  • Alba Belles,
  • Mercè García González,
  • Miriam Valverde Troya,
  • Begoña Palop,
  • Fernando García Garrote,
  • Jose Luis Barrios Andrés,
  • Leyre López Soria,
  • Adelina Gimeno,
  • Ester Clapés Sanchez,
  • Jennifer Villa,
  • Nuria Iglesias Nuñez,
  • Rafael Sánchez Arroyo,
  • Susana Hernando,
  • Eva Riquelme Bravo,
  • Caridad Sainz de Baranda,
  • Oscar Esparcia Rodríguez,
  • Jorge Gaitán,
  • María Huertas,
  • M. José Rodríguez Escudero,
  • Carmen Aldea,
  • Nerea Sanchez,
  • Antonio Casabella Pernas,
  • Ma Dolores Quesada,
  • Carmina Martí Sala,
  • Laura Mora,
  • Encarnación Clavijo,
  • Natalia Chueca,
  • Federico Juan Manuel GarcíaSánchez,
  • Fátima Galán Sánchez,
  • Carmen Liébana,
  • Carolina Roldán,
  • Ma Isabel Cabeza,
  • Ma Teresa Cabezas Fernández,
  • Lucía Martínez Lamas,
  • Sonia Rey Cao,
  • Ma Isabel Paz Vidal,
  • Raquel Elisa Rodríguez Tarazona y Noelia Arenal Andrés,
  • Amparo Coira Nieto,
  • Ma Luisa Pérez del Molino Bernal,
  • María Gomáriz Díaz,
  • Matxalen Vidal-García,
  • Jose Luis de Tuesta Díaz,
  • Moises García Bravo,
  • Almudena Tinajas,
  • Fe Tubau Quintano,
  • Borja Suberviola Cañas y Maria Eliecer Cano García,
  • Irene Gracia-Ahufinger,
  • Mónica González Bardanca,
  • Belén Viñado,
  • Xavier Nuvials,
  • Ignasi Roca,
  • Patricia Ruiz-Garbajosa,
  • Desireé Gijon,
  • Vicente Pintado,
  • Alba Rivera,
  • David Gutiérrez Campos,
  • Aurora Alemán,
  • Ignacio Ayestarán,
  • Andrés Canut Blasco y Jorge Arribas García

摘要

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.