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Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceaein North-Eastern France and outcomes of infected patients

Muggeo, Anaëlle ; Guillard, Thomas ; Barbe, Coralie ; Thierry, Aurore ; Bajolet, Odile ; Vernet-Garnier, Véronique ; Limelette, Anne ; Brasme, Lucien ; De Champs, Christophe

Journal of antimicrobial chemotherapy, 2017-05, Vol.72 (5), p.1496-1501 [Periódico revisado por pares]

England

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Título:
Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceaein North-Eastern France and outcomes of infected patients
Autor: Muggeo, Anaëlle ; Guillard, Thomas ; Barbe, Coralie ; Thierry, Aurore ; Bajolet, Odile ; Vernet-Garnier, Véronique ; Limelette, Anne ; Brasme, Lucien ; De Champs, Christophe
Assuntos: Aged ; Aged, 80 and over ; Anti-Bacterial Agents - adverse effects ; Anti-Bacterial Agents - pharmacology ; Carbapenem-Resistant Enterobacteriaceae - drug effects ; Carbapenem-Resistant Enterobacteriaceae - isolation & purification ; Carbapenems - adverse effects ; Carbapenems - pharmacology ; Carbapenems - therapeutic use ; Carrier State - epidemiology ; Carrier State - microbiology ; Case-Control Studies ; Cross Infection ; Enterobacter cloacae - drug effects ; Enterobacter cloacae - isolation & purification ; Enterobacteriaceae Infections - epidemiology ; Enterobacteriaceae Infections - microbiology ; Female ; France - epidemiology ; Hospitals ; Humans ; Klebsiella Infections - epidemiology ; Klebsiella pneumoniae - drug effects ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Risk Factors
É parte de: Journal of antimicrobial chemotherapy, 2017-05, Vol.72 (5), p.1496-1501
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Carbapenems are frequently used as a last resort to treat infections caused by multidrug-resistant Gram-negative organisms, thus carbapenem-non-susceptible Enterobacteriaceae (CNSE) is an emerging health threat. To assess risk factors and outcomes of CNSE carriage. We conducted a matched case-control study in six hospitals in North-Eastern France. The controls were patients harbouring carbapenem-susceptible Enterobacteriaceae. Fifty-five cases and 110 controls were included. Most of the CNSE isolates were Enterobacter cloacae and Klebsiella pneumoniae . Carbapenemase production was observed in 40% of isolates and they produced OXA-48 only. CNSE carriage was significantly associated with recent antibiotic use ( P = 0.014), particularly carbapenems ( P = 0.03) and fluoroquinolones ( P = 0.016). A multivariate analysis using conditional logistic regression showed that the presence of concomitant infection(s) (OR: 9.83; 95% CI 3.04-21.39, P = 0.0031), nosocomial infections (OR: 7.84; 95% CI 2.00-12.54, P = 0.0063) and a high age (OR: 1.07; 95% CI 1.01-1.06, P = 0.038) were independently associated with CNSE carriage. Moreover, patients infected with CNSE had worse outcomes: fewer resolved infections at 1 month ( P = 0.02), and they had a higher mortality rate ( P = 0.0004) and longer hospital stays ( P = 0.02). We identified three independent risk factors for CNSE carriage as well as worse outcomes in infected patients in North-Eastern France. This highlights the importance of early detection of CNSE and the need for antimicrobial therapy re-evaluation after bacteriological analysis has been performed.
Editor: England
Idioma: Inglês

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Factors associated with carriage of carbapenem-non-susceptible Enterobacteriaceaein North-Eastern France and outcomes of infected patients

Muggeo, Anaëlle ; Guillard, Thomas ; Barbe, Coralie ; Thierry, Aurore ; Bajolet, Odile ; Vernet-Garnier, Véronique ; Limelette, Anne ; Brasme, Lucien ; De Champs, Christophe

England

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