Multicenter Clinical And Molecular Epidemiological Analysis Of Bacteremia Due To Carbapenem-Resistant Enterobacteriaceae Cre In The Cre Epicenter Of The United States

Multicenter Clinical And Molecular Epidemiological Analysis Of Bacteremia Due To Carbapenem-Resistant Enterobacteriaceae Cre In The Cre Epicenter Of The United States

Download This Complete Project Topic And Material (Chapter 1-5 With References and Questionnaire) Titled Multicenter Clinical And Molecular Epidemiological Analysis Of Bacteremia Due To Carbapenem-Resistant Enterobacteriaceae Cre In The Cre Epicenter Of The United States. Here On ProjectGate. See Below For The Abstract, Table Of Contents, List Of Figures, List Of Tables, List Of Appendices, List Of Abbreviations, And Chapter One. Click The Download Now Button Below To Get The Complete Project Work Instantly.

PROJECT TOPIC AND MATERIAL ON MULTICENTER CLINICAL AND MOLECULAR EPIDEMIOLOGICAL ANALYSIS OF BACTEREMIA DUE TO CARBAPENEM-RESISTANT ENTEROBACTERIACEAE CRE IN THE CRE EPICENTER OF THE UNITED STATES

The Project File Details

  • Name: Multicenter Clinical And Molecular Epidemiological Analysis Of Bacteremia Due To Carbapenem-Resistant Enterobacteriaceae Cre In The Cre Epicenter Of The United States
  • Type: PDF and MS Word (DOC)
  • Size: [70 KB]
  • Length: [56] Pages

 

 

 

ABSTRACT

Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniaeEnterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC-Kp). The wzi154 allele, corresponding to cps-2, was present in 93% of KPC-3-Kp, whereas KPC-2-Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3-Kp had an CAZ-AVI MIC of ≥4/4 μg/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3-Kp bacteremia (adjusted odds ratio [aOR], 2.58; P = 0.045), cancer (aOR, 3.61, P = 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P = 0.03) were independently associated with mortality. Active empirical therapy and combination therapy were not associated with survival. Despite a decade of experience with CRE, patients with CRE bacteremia have protracted delays in appropriate therapies and high mortality rates, highlighting the need for rapid diagnostics and evaluation of new therapeutics.


GET THE COMPLETE PROJECT»


Be the first to comment

Leave a Reply

Your email address will not be published.


*