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Purpose: This study aimed to assess the prevalence and characteristics of carbapenemase-producing Enterobacterales (CPE) carriage among patients who were admitted to hematology units to identify risk factors for CPE carriage. Methods: This retrospective case-control study was carried out at a tertiary hospital, with a specific focus on adult patients (18 years of age or older) who were admitted to the hematology department. The cases comprised 73 patients with CPE, while the controls comprised 292 individuals matched randomly in a 1:4 ratio according to gender and age. A retrospective review of electronic medical records was conducted to collect data using a CPE acquisition risk factor questionnaire. Patient characteristics, drugs used, and the duration of use were compared between two groups using univariate analysis, and the risk factors associated with CPE were analyzed using multiple logistic regression analysis. Results: The research findings indicated a prevalence of CPE of 5.4%. The predominant strain identified was Klebsiella pneumoniae, and the primary genotype identified was New Delhi metallo-beta-lactamase (NDM). A history of surgery and use of penicillin-based antibiotics were identified as risk factors for CPE carriage. Conclusion: The results emphasize the importance of establishing specific criteria when proactively screening high-risk patients for CPE. Furthermore, these findings provide evidence for forecasting risk factors associated with CPE and devising efficacious preventive measures. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify the colonization rate of carbapenem-resistant Enterobacteriaceae (CRE), the characteristics of CRE isolates, and risk factors for CRE colonization in patients transferred to the general wards of a small/medium-sized hospital. Methods: This retrospective study was conducted on patients who underwent CRE culture tests within 24 hours of admission among patients transferred to a small/medium-sized hospital. Forty-seven patients confirmed as positive for CRE were classified as belonging to the patient group. For the control group, 235 patients (five times the number of the patient group) were matched by sex, age, and diagnosis, and then selected at random. Data were analyzed using descriptive analysis and multiple logistic regression analysis. Results: The CRE colonization rate was 5% (47 out of 933 patients), and Klebsiella pneumoniae (68.0%) was the most common isolate of CRE. The positivity rate of carbapenemase-producing Enterobacteriaceae was 61.7%. The risk factors for CRE colonization included renal disease (odds ratio [OR]=4.93; 95% confidence interval [CI], 1.49-16.31), heart disease (OR=3.86; 95% CI, 1.35-11.01), indwelling urinary catheters (OR=4.43; 95% CI, 1.59-12.36), and cephalosporin antibiotic use (OR=8.57; 95% CI, 1.23-59.60). Conclusion: Having a comorbid renal or cardiac disease, an indwelling urinary catheter, or a history of exposure to cephalosporin antibiotics could be classified as risk factors for CRE colonization in patients transferred to small and medium-size hospitals. It is necessary to perform active infection control through proactive CRE culture testing of patients with risk factors. [ABSTRACT FROM AUTHOR]

Background: Increase in antimicrobial-resistant bacteria continues to be challenge to physicians. Particularly, multidrug-resistant (MDR) gram-negative bacilli (GNB), such as extended-spectrum beta-lactamase (ESBL)- producers and carbapenem-resistant pathogens, are becoming a major human health problem globally. Current Concepts: Gram-negative bacteria have developed resistance via mechanisms encoding AmpC betalactamases, ESBLs, and carbapenemases. The therapeutic options available for these pathogens are extremely limited. Infection by MDR bacteria is associated with ineffective antimicrobial therapy, which poses a major threat to the survival of patients with serious infections. Physicians should be familiar with the local epidemiology of MDR bacterial infections and the available therapeutic options. Carbapenems are considered as the drugs of choice for treating ESBL or AmpC-producers. However, increased use of carbapenems in response to an increased prevalence of MDR pathogens could be associated with the rapid emergence of carbapenem resistance. Therefore, there is an ongoing quest for carbapenem-sparing regimens for the treatment of MDR-GNB. Treatment of MDR-GNB infections need not be limited to carbapenems as novel antimicrobial agents are now available. Discussion and Conclusion: This comprehensive review aims to describe therapeutic options available for MDR-GNB infections in Korea, a country with a high prevalence of MDR pathogens. Recently developed antimicrobial agents that should be urgently introduced in Korea include ceftolozane-tazobactam, ceftazidimeavibactam, meropenem-vaborbactam, imipenem-relebactam, and cefiderocol. These drugs have been shown to be effective against carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa, and Acinetobacter baumannii. [ABSTRACT FROM AUTHOR]