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Open Access 04-05-2024 | Escherichia Coli | Research

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

Authors: 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, The GEMARA/GEIRAS-SEIMC/REIPI CARB–ES–19 Group

Published in: Infection

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Abstract

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.
Literature
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go back to reference Cañada-García JE, Moure Z, Sola-Campoy PJ, Delgado-Valverde M, Cano ME, Gijón D, et al. CARB-ES-19 multicenter study of carbapenemase-producing klebsiella pneumoniae and escherichia coli from all Spanish provinces reveals interregional spread of high-risk clones such as ST307/OXA-48 and ST512/KPC-3. Front Microbiol. 2022;30(13): 918362. https://doi.org/10.3389/fmicb.2022.918362.CrossRef Cañada-García JE, Moure Z, Sola-Campoy PJ, Delgado-Valverde M, Cano ME, Gijón D, et al. CARB-ES-19 multicenter study of carbapenemase-producing klebsiella pneumoniae and escherichia coli from all Spanish provinces reveals interregional spread of high-risk clones such as ST307/OXA-48 and ST512/KPC-3. Front Microbiol. 2022;30(13): 918362. https://​doi.​org/​10.​3389/​fmicb.​2022.​918362.CrossRef
Metadata
Title
Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain
Authors
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
The GEMARA/GEIRAS-SEIMC/REIPI CARB–ES–19 Group
Publication date
04-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Infection
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-024-02267-0
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