Clinical, epidemiological and microbiological characterization of bacteremia produced by carbapenem-resistant enterobacteria in a university hospital in Córdoba, Argentina

• Published in: Revista chilena de infectología Vol. 37; no. 4; pp. 362 - 370
• Main Authors: Lipari, Flavio G, Hernández, Daniela, Vilaró, Mario, Caeiro, Juan P, Saka, Héctor Alex
• Format: Journal Article
• Language: Spanish
• Published: Chile 01.08.2020
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Argentina - epidemiology; Bacteremia - drug therapy; Bacteremia - epidemiology; beta-Lactamases; Carbapenems - pharmacology; Drug Resistance, Bacterial; Enterobacteriaceae; Humans; Klebsiella Infections - drug therapy; Klebsiella Infections - epidemiology; Klebsiella pneumoniae; Microbial Sensitivity Tests; Retrospective Studies; Argentina
• ISSN: 0717-6341
• DOI: 10.4067/S0716-10182020000400362

Enterobacteriaceae are a major cause of bloodstream infections and their antimicrobial resistance continues to increase. This leads to higher morbidity-mortality rates and public health costs. Carbapenem-resistant Enterobacteriaceae represent a serious challenge globally, since there are few therapeutic options available. Clinical/microbiological characterization of the carbapenem-resistant bacteremia observed over a period of 4 years. Retrospective, observational and descriptive study about bacteremia caused by carbapenem-resistant and susceptible Enterobacteriaceae. A total of 84 patients with bacteremia including carbapenem-resistant and susceptible Enterobacteriaceae were analyzed. We found that patients infected with carbapenem-resistant strains presented a higher proportion of: previous antibiotic treatment, hospitalization in intensive care unit (ICU), onset of the bacteremia during hospitalization in ICU and previous infection with extended-spectrum-beta-lactamase producing Enterobacteriaceae. Additionally, we observed a predominance of KPC-producing Klebsiella pneumoniae and an attributable mortality rate of 52.4%. This study allowed for a better understanding of an emerging problem with high mortality, which in turn is useful for the design and adoption of infection control strategies and effective treatment regimens adapted to our local epidemiology.