Treatment options and clinical outcomes for carbapenem-resistant Enterobacteriaceae bloodstream infection in a Chinese university hospital

Abstract

Our study demonstrated a high mortality associated with CRE BSI and a high percentage of inappropriate empirical treatment for CRE BSI patients in a Chinese teaching hospital. Particular attention should be given to the patients with CRE BSI.

Predictors of mortality in solid organ transplant recipients with bloodstream infections due to carbapenemase-producing Enterobacterales: The impact of cytomegalovirus disease and lymphopenia

“…15,21,22 The development of the new INCREMENT-SOT-CPE score was based on the INCREMENT-CPE score, which had been previously validated in the general population in different studies. 9,11,12,23,24 We used this strategy because there are no specific studies in SOT and many transplant groups use this predictive model, which takes into account variables important in any type of patient with BSI, including SOT. Besides, the inclusion of this general model in our new score reinforces the utility of the new model in posttransplant periods, such as the postoperative period, when the full impact of immunosuppression-derived from prolonged exposure to suppressive therapies-is still absent.…”

It’s Not Easy Being Green: A Narrative Review on the Microbiology, Virulence and Therapeutic Prospects of Multidrug-Resistant Pseudomonas aeruginosa

“…The discovery of IMP-1 was followed by the description of VIM-1 (1997; Verona Imipenemase 1, VIM-1) in a P. aeruginosa isolate [218]; in both cases, genes coding for the MBL were found on a gene cassette inserted into a class 1 integron. Since then, a variety of novel MBLs have been described in Gram-negative bacteria, including AIM (Australian Imipenemase), DIM (Dutch Imipenemase), GIM (German Imipenemase), KHM (Kyorin University Hospital), NDM (New Delhi MBL), SIM (Seul Imipenemase), SPM (Sao Paulo MBL), and TMB (Tripoli MBL) [219,220]. In laboratory conditions, carbapenemases may be differentiated through the inhibition of various molecules (e.g., ethylenediaminetetraacetic acid for MBLs, boronic acid for serine-type enzymes), but it is more difficult to carry out due to the low outer membrane permeability of P. aeruginosa, which may significantly alter the resistance phenotype [221,222].…”

<p>Predictors of Mortality in Patients with Carbapenem-Resistant Gram-Negative Bacilli or Vancomycin-Resistant Enterococci Bacteremia</p>

“…In another study of 90 patients, non-significant adverse outcomes appeared to be more likely among patients with previous carbapenem exposure and neutropenia and were related to the severity of septicemia and time to initiation of bloodstream infection. 19 However, given the increased number of CRGNB or VRE carriers or bacteremia cases, we think that our study findings are credible and important. A study on CRE bacteremia showed that KPC-3-Kp bacteremia and bacteremia onset in the intensive care unit were independently associated with mortality.…”

“…A study on CRE bacteremia showed that KPC-3-Kp bacteremia and bacteremia onset in the intensive care unit were independently associated with mortality. 11,19 Presently, we did not analyze the type of resistance. However, other studies reported no difference between carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE infections.…”

“…This may be because there were few bacteremia cases. 13 , 18 , 19 Our study overcame this limitation because of the relatively large number of patients and the identification of significant risk factors, including positive FUBC and PBS.…”