Study Identifies Risk Factors for Carbapenem Resistance

Authors analyze more than 10,000 patients

New data identifying hospitalized patients with serious infections due to Enterobactericaeae who are at increased risk for developing carbapenem-resistant Enterobacteriaceae (CRE) infections have been presented at IDWeek 2016 in New Orleans.

The Centers for Disease Control and Prevention has identified CRE as one of the three most-urgent public health threats. CRE is attributed to approximately 9,000 health care-associated infections each year, with 600 deaths per year resulting from the two most-common types of CRE––carbapenem-resistant Klebsiella species and carbapenem-resistant Escherichia coli.

A retrospective, observational study evaluated 10,634 U.S. patients with invasive hospital-onset infections due to Enterobacteriaceae in the Premier hospital database between January 2011 and December 2014. The overall prevalence of CRE in this total population was 4.5% (481/10,634). Enterobacteriaceae were considered carbapenem-resistant if they were documented as nonsusceptible to meropenem, imipenem, doripenem, or ertapenem.

The study found that the following factors were associated with an increased risk of CRE:

  • A baseline CRE prevalence of greater than 2% in the hospital where the patient is admitted
  • Dialysis during the current hospital admission
  • Evidence of an infection during the three months before the current hospital admission
  • The cumulative number of prior antibiotic exposures during the current hospital admission and previous admissions

“Physicians in the hospital setting are under pressure to quickly act when evaluating and determining appropriate treatment options for admitted patients with serious infections,” said lead investigator Tom Lodise, PharmD, PhD. “These data are critically important for health care professionals prioritizing new information on CRE prevalence and risk factors associated with the probability of a CRE infection.”

Source: Allergan; October 29, 2016.