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KPC-producing Enterobacter aerogenes infection
Felipe F Tuon1, Camila Scharf1, Jaime L Rocha2
1Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brazil.
Background:
Enterobacter is a common nosocomial microorganism and its carbapenem's resistance has increased. The management of these cases is unclear.
Objective:
We evaluated 16 patients with KPC-producing Enterobacter aerogenes infections, detailing the site of infection, therapy, clinical and epidemiological data.
Methods:
A retrospective and descriptive study. Clinical data were revised and KPC-2 detection was by molecular methods. Risk factors associated with mortality were compared using appropriate tests according to variable type with a significance level of 0.05.
Results:
The 30-day mortality rate was 37.5% with no association with inadequate treatment. Age (p=0.004) and Charlson score of comorbidities (p=0.048) were independent risk factors associated with death in the multivariate analysis. The odds ratio for age >43 years was 3.00 (95% CI: 1.02-9.32) and for Charlson score >3 was 2.00 (95% CI: 1.08-3.71). Five strains were pan-resistant based on automated susceptibility tests. All patients were treated with monotherapy.
Conclusion:
The clinician should be alert to carbapenem-resistant Enterobacteriaceae infection in older patients with comorbidities. The mortality is high and we believe that prompt and adequate therapy must be employed.
Insights
Carbapenem-resistant Enterobacter aerogenes infections are a growing concern, particularly in older patients with comorbidities. High mortality rates underscore the need for prompt and effective treatment strategies for these difficult-to-manage nosocomial infections.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Rising rates of carbapenem resistance in nosocomial pathogens like Enterobacter.
- Limited clarity on optimal management strategies for carbapenem-resistant Enterobacter infections.
Purpose of the Study:
- To evaluate clinical and epidemiological data of patients with KPC-producing Enterobacter aerogenes infections.
- To identify risk factors associated with mortality in these patients.
Main Methods:
- Retrospective and descriptive study design.
- Molecular methods for KPC-2 detection.
- Statistical comparison of risk factors for mortality.
Main Results:
- 30-day mortality rate of 37.5% observed.
- Age and Charlson comorbidity score were independent risk factors for death.
- Five strains exhibited pan-resistance; all patients received monotherapy.
Conclusions:
- Clinicians must be vigilant for carbapenem-resistant Enterobacteriaceae in elderly patients with comorbidities.
- High mortality necessitates prompt and adequate therapeutic interventions.
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