1. Risk factors for infections caused by carbapenem-resistant Enterobacterales: an international matched case-control-control study (EURECA)Research in context
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Salvador Pérez-Galera, Jose M. Bravo-Ferrer, María Paniagua, Tomislav Kostyanev, Marlieke E.A. de Kraker, Jan Feifel, Jesús Sojo-Dorado, Joost Schotsman, Rafael Cantón, George L. Daikos, Biljana Carevic, Gorana Dragovac, Lionel K. Tan, Lul Raka, Adriana Hristea, Pierluigi Viale, Murat Akova, Jose María Reguera, Lucía Valiente de Santis, Julián Torre-Cisneros, Ángela Cano, Emmanuel Roilides, Lili Radulovic, Cenk Kirakli, Evelyn Shaw, Matthew E. Falagas, Vicente Pintado, Herman Goossens, Marc J. Bonten, Belén Gutiérrez-Gutiérrez, Jesús Rodriguez-Baño, Almudena de la Serna, Sophie Monteau, Virginia Palomo, Elena Soriano, David Gutierrez, Elisa Moreno, Zaira Palacios, Isabel Morales, Natalia Maldonado, Antonio Plata Ciezar, Juan Diego Ruiz Mesa, Beatriz Sobrino Diaz, Ignacio Marquez Gomez, Ines Perez Camacho, Azahara Frutos-Adame, Julia Guzman-Puche, Irene Gracia-Ahufinger, Elena Perez-Nadales, Julian Torre-Gimenez, Athina Pyrpasopoulou, Elias Iosifidis, Elsa Chorafa, Ivana Radovanovic, Sladjana Petrovic, Slavica Cvetkovi, Srdjan-Sanja Melentijevic, Can Bicmen, Gunes Senol, Fe Tubau, Jordi Camara, Victor Daniel Gumucio, Dimitris Bassoulis, John Deliolanis, Vassiliki Ch. Pitiriga, Nikolaos Triarides, Efstathia Argiti, Nikolaos J. Legakis, Kyriakidou Margarita, Desirée Gijón-Cordero, Patricia Ruiz-Garbajosa, Alessandro Bartoloni, Gian Maria Rossolini, Simin-Aysel Florescu, Maria Nica, Serban Benea, Daniela Talapan, Deana Medić, Sanja Maričić Prijić, Mireia Cantero Caballero, Lina M. Parra Ramírez, Volkan Korten, Hüseyin Bilgin, George N. Dalekos, Aggelos Stefos, Nikolaos Spyridis, Athanasios Michos, Francesco Giuseppe De Rosa, Rossana Cavallo, Nicola Petrosillo, Antonio Dicaro, Maria Paola Landini, Marta Luisa Ciofi degli Atti, Mileva Masanovic, Dusan Matkovic, Sotirios Tsiodras, Francesco Blasi, Marta Di pasquale, Claudio Viscoli, Andrei Vata, Olivia Dorneanu, Perlat Kapisyzi, Adriana Vince, Evdoxia Tsigou, Efstratios Maltezos, Apostolos Komnos, Charalampos Gogos, Fabio Franzetti, Massimo Antonelli, Mihaela Lupse, Dan Corneci, Dana Tomescu, Anca Georgescu, Ljiljana Bukarica, Goran Mitrović, Nataša Lukić Krstić, Arsim Kurti, Beatriz Díaz-Pollán, Julia Origüen Sabater, Patricia Muñoz, Alpay Azap, Banu Sancak, Arife Sahin, and Halis Akalin
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Antimicrobial resistance ,Carbapenem-resistant Enterobacterales ,Risk factors ,KPC ,OXA ,Metallo-beta-lactamases ,Medicine (General) ,R5-920 - Abstract
Summary: Background: Data on risk factors for carbapenem-resistant Enterobacterales (CRE) with wider applicability are needed to inform preventive measures and efficient design of randomised trials. Methods: An international matched case-control-control study was performed in 50 hospitals with high CRE incidence from March 2016 to November 2018 to investigate different aspects of infections caused by CRE (NCT02709408). Cases were patients with complicated urinary tract infection (cUTI), complicated intraabdominal (cIAI), pneumonia or bacteraemia from other sources (BSI-OS) due to CRE; control groups were patients with infection caused by carbapenem-susceptible Enterobacterales (CSE), and by non-infected patients, respectively. Matching criteria included type of infection for CSE group, ward and duration of hospital admission. Conditional logistic regression was used to identify risk factors. Findings: Overall, 235 CRE case patients, 235 CSE controls and 705 non-infected controls were included. The CRE infections were cUTI (133, 56.7%), pneumonia (44, 18.7%), cIAI and BSI-OS (29, 12.3% each). Carbapenemase genes were found in 228 isolates: OXA-48/like, 112 (47.6%), KPC, 84 (35.7%), and metallo-β-lactamases, 44 (18.7%); 13 produced two. The risk factors for CRE infection in both type of controls were (adjusted OR for CSE controls; 95% CI; p value) previous colonisation/infection by CRE (6.94; 2.74–15.53;
- Published
- 2023
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