Risk factors for clinical treatment failure regarding carbapenem-resistant Enterobacterales in the southwestern United States
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View abstract on PubMed
Summary
This summary is machine-generated.Carbapenem-resistant Enterobacterales (CRE) infections are rising, with New Delhi metallo-beta-lactamases (NDM) becoming more common in the Southwest US. Risk factors for treatment failure include ICU admission and prior hospitalization.
Area Of Science
- Infectious Diseases
- Microbiology
- Public Health
Background
- Carbapenem-resistant Enterobacterales (CRE) infections pose a growing threat in the US, causing significant illness and death.
- Klebsiella pneumoniae carbapenemases (KPC) were historically dominant, but regional shifts in carbapenemase types are occurring.
Purpose Of The Study
- To investigate the changing epidemiology of CRE in the southwestern United States.
- To identify risk factors associated with treatment failure in CRE infections.
Main Methods
- A retrospective observational study was conducted across 33 acute care hospitals in the southwestern US.
- Data from 169 patients aged 18 or older with carbapenem-resistant infections between January 1, 2023, and July 31, 2023, were analyzed.
Main Results
- Klebsiella pneumoniae was the most prevalent CRE species (82%), with metallo beta-lactamases (MBLs), particularly New Delhi metallo-beta-lactamases (NDMs), being the most common carbapenemase (76%).
- Independent risk factors for treatment failure included renal replacement therapy (OR 2.44), prior hospitalization within 90 days (OR 2.69), and ICU admission (OR 5.55).
Conclusions
- The study reveals a concerning increase in NDM-producing CRE in the southwestern US, especially Arizona.
- Close evaluation of patient risk factors is crucial for selecting effective empiric therapy against CRE infections.
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