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Zhou R, Fang X, Zhang J, Zheng X, Shangguan S, Chen S, Shen Y, Liu Z, Li J, Zhang R, Shen J, Walsh TR, Wang Y. Impact of carbapenem resistance on mortality in patients infected with Enterobacteriaceae: a systematic review and meta-analysis. BMJ Open 2021; 11:e054971. [PMID: 34907071 PMCID: PMC8672018 DOI: 10.1136/bmjopen-2021-054971] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES To provide a comprehensive assessment of the impact of carbapenem resistance on mortality among patients infected with Enterobacteriaceae and to explore the source of heterogeneity across studies. DESIGN This systematic review was conducted following the guidelines of Cochrane Guidance and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DATA SOURCES We conducted a systematic literature search of the PubMed, Embase, Web of Science and Cochrane Library databases to identify relevant studies published between 1 January 1994 and 30 August 2020. ELIGIBILITY CRITERIA We included primary observational studies published in English that reported the mortality outcomes for hospitalised patients with confirmed infections due to carbapenem-resistant Enterobacteriaceae (CRE) and carbapenem-susceptible Enterobacteriaceae (CSE). Studies with no comparison group or with a comparison group of patients infected with unconfirmed CSE were excluded. DATA EXTRACTION AND SYNTHESIS Data extraction and assessment of risk bias were conducted independently by two reviewers. The pooled relative risk and risk difference were calculated as effect measures with 95% CIs using a random effects model. The heterogeneity across studies was assessed by Q-statistic and I2 measures. RESULTS Of 10 304 studies initially identified, 50 studies were included in the meta-analyses. The results of the meta-analyses showed that carbapenem resistance has a significant positive effect on the probability of death for patients infected with Enterobacteriaceae for any type of mortality outcome. The results of the stratified analysis and meta-regression suggested that the effect of carbapenem resistance on the risk of death varied by infection type, sample size and year of publication. CONCLUSIONS Our results suggested that patients with CRE infection still face a greater risk of death than patients with CSE infection do, and an urgent need to develop new antibiotics and appropriate treatments to reduce the risk of death. PROSPERO REGISTRATION NUMBER CRD42020176808.
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Affiliation(s)
- Ruyin Zhou
- Department of Economics and Trade, College of Economics and Management, China Agricultural University, Beijing, China
| | - Xiangming Fang
- Department of Economics and Trade, College of Economics and Management, China Agricultural University, Beijing, China
- Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Jinjin Zhang
- Department of Economics and Trade, College of Economics and Management, China Agricultural University, Beijing, China
| | - Xiaodong Zheng
- Department of Economics, School of Economics, Zhejiang Gongshang University, Hangzhou, China
| | - Shuangyue Shangguan
- Department of Economics and Trade, College of Economics and Management, China Agricultural University, Beijing, China
| | - Shibo Chen
- Department of Basic Veterinary Medicine, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | - Yingbo Shen
- CAS Key Laboratory of Pathogenic Microbiology and Immunology, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China
| | - Zhihai Liu
- Agricultural Bio-pharmaceutical Laboratory, College of Chemistry and Pharmaceutical Sciences, Qingdao Agricultural University, Qingdao, China
| | - Juan Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
| | - Rong Zhang
- Clinical Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University, Zhejiang University, Hangzhou, China
| | - Jianzhong Shen
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, China
| | | | - Yang Wang
- Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety, College of Veterinary Medicine, China Agricultural University, Beijing, China
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Garza-González E, Bocanegra-Ibarias P, Bobadilla-del-Valle M, Ponce-de-León-Garduño LA, Esteban-Kenel V, Silva-Sánchez J, Garza-Ramos U, Barrios-Camacho H, López-Jácome LE, Colin-Castro CA, Franco-Cendejas R, Flores-Treviño S, Morfín-Otero R, Rojas-Larios F, Mena-Ramírez JP, Fong-Camargo MG, Morales-De-la-Peña CT, García-Mendoza L, Choy-Chang EV, Aviles-Benitez LK, Feliciano-Guzmán JM, López-Gutiérrez E, Gil-Veloz M, Barajas-Magallón JM, Aguirre-Burciaga E, López-Moreno LI, Martínez-Villarreal RT, Canizales-Oviedo JL, Cetina-Umaña CM, Romero-Romero D, Bello-Pazos FD, Barlandas-Rendón NRE, Maldonado-Anicacio JY, Bolado-Martínez E, Galindo-Méndez M, Perez-Vicelis T, Alavez-Ramírez N, Méndez-Sotelo BJ, Cabriales-Zavala JF, Nava-Pacheco YC, Moreno-Méndez MI, García-Romo R, Silva-Gamiño AR, Avalos-Aguilera AM, Santiago-Calderón MA, López-García M, Velázquez-Acosta MDC, Cobos-Canul DI, Vázquez-Larios MDR, Ortiz-Porcayo AE, Guerrero-Núñez AE, Valero-Guzmán J, Rosales-García AA, Ostos-Cantú HL, Camacho-Ortiz A. Drug resistance phenotypes and genotypes in Mexico in representative gram-negative species: Results from the infivar network. PLoS One 2021; 16:e0248614. [PMID: 33730101 PMCID: PMC7968647 DOI: 10.1371/journal.pone.0248614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 02/16/2021] [Indexed: 12/14/2022] Open
Abstract
Aim This report presents phenotypic and genetic data on the prevalence and characteristics of extended-spectrum β-lactamases (ESBLs) and representative carbapenemases-producing Gram-negative species in Mexico. Material and methods A total of 52 centers participated, 43 hospital-based laboratories and 9 external laboratories. The distribution of antimicrobial resistance data for Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae complex, Acinetobacter baumannii complex, and Pseudomonas aeruginosa in selected clinical specimens from January 1 to March 31, 2020 was analyzed using the WHONET 5.6 platform. The following clinical isolates recovered from selected specimens were included: carbapenem-resistant Enterobacteriaceae, ESBL or carbapenem-resistant E. coli, and K. pneumoniae, carbapenem-resistant A. baumannii complex, and P. aeruginosa. Strains were genotyped to detect ESBL and/or carbapenemase-encoding genes. Results Among blood isolates, A. baumannii complex showed more than 68% resistance for all antibiotics tested, and among Enterobacteria, E. cloacae complex showed higher resistance to carbapenems. A. baumannii complex showed a higher resistance pattern for respiratory specimens, with only amikacin having a resistance lower than 70%. Among K. pneumoniae isolates, blaTEM, blaSHV, and blaCTX were detected in 68.79%, 72.3%, and 91.9% of isolates, respectively. Among E. coli isolates, blaTEM, blaSHV, and blaCTX were detected in 20.8%, 4.53%, and 85.7% isolates, respectively. For both species, the most frequent genotype was blaCTX-M-15. Among Enterobacteriaceae, the most frequently detected carbapenemase-encoding gene was blaNDM-1 (81.5%), followed by blaOXA-232 (14.8%) and blaoxa-181(7.4%), in A. baumannii was blaOXA-24 (76%) and in P. aeruginosa, was blaIMP (25.3%), followed by blaGES and blaVIM (13.1% each). Conclusion Our study reports that NDM-1 is the most frequent carbapenemase-encoding gene in Mexico in Enterobacteriaceae with the circulation of the oxacillinase genes 181 and 232. KPC, in contrast to other countries in Latin America and the USA, is a rare occurrence. Additionally, a high circulation of ESBL blaCTX-M-15 exists in both E. coli and K. pneumoniae.
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Affiliation(s)
- Elvira Garza-González
- Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Paola Bocanegra-Ibarias
- Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | - Verónica Esteban-Kenel
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | | | | | | | - Luis Esaú López-Jácome
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | | | - Rafael Franco-Cendejas
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
| | - Samantha Flores-Treviño
- Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Rayo Morfín-Otero
- Hospital Civil de Guadalajara E Instituto de Patología Infecciosa, Guadalajara, Jalisco, Mexico
| | | | - Juan Pablo Mena-Ramírez
- Hospital General de Zona 21 Tepatitlán De Morelos, Centro Universitario de los Altos (CUALTOS), Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, Mexico
| | | | | | | | | | | | | | | | - Mariana Gil-Veloz
- Hospital Regional de Alta Especialidad del Bajío, Guanajuato, Guanajuato, Mexico
| | | | | | | | | | - Jorge Luis Canizales-Oviedo
- Centro Universitario de Salud, Universidad Autónoma de Nuevo León. Laboratorio Pueblo Nuevo, Monterrey Nuevo León, Mexico
| | | | - Daniel Romero-Romero
- Laboratorio de Análisis Bioquímico Clínicos "Louis Pasteur" Toluca, Estado de México, Mexico
| | | | | | | | | | | | - Talia Perez-Vicelis
- Hospital Regional "Bicentenario de la Independencia” ISSSTE, Tultitlán, Estado de México, Mexico
| | - Norma Alavez-Ramírez
- Hospital Regional "Bicentenario de la Independencia” ISSSTE, Tultitlán, Estado de México, Mexico
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Adrián Camacho-Ortiz
- Hospital Universitario Dr. José E. González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
- * E-mail:
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García-Betancur JC, Appel TM, Esparza G, Gales AC, Levy-Hara G, Cornistein W, Vega S, Nuñez D, Cuellar L, Bavestrello L, Castañeda-Méndez PF, Villalobos-Vindas JM, Villegas MV. Update on the epidemiology of carbapenemases in Latin America and the Caribbean. Expert Rev Anti Infect Ther 2020; 19:197-213. [PMID: 32813566 DOI: 10.1080/14787210.2020.1813023] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Carbapenemases are β-lactamases able to hydrolyze a wide range of β-lactam antibiotics, including carbapenems. Carbapenemase production in Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp., with and without the co-expression of other β-lactamases is a serious public health threat. Carbapenemases belong to three main classes according to the Ambler classification: class A, class B, and class D. AREAS COVERED Carbapenemase-bearing pathogens are endemic in Latin America. In this review, we update the status of carbapenemases in Latin America and the Caribbean. EXPERT OPINION Understanding the current epidemiology of carbapenemases in Latin America and the Caribbean is of critical importance to improve infection control policies limiting the dissemination of multi-drug-resistant pathogens and in implementing appropriate antimicrobial therapy.
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Affiliation(s)
| | - Tobias Manuel Appel
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia
| | - German Esparza
- Programa de Aseguramiento de Calidad. PROASECAL SAS, Bogotá, Colombia
| | - Ana C Gales
- Division of Infectious Diseases, Department of Internal Medicine, Escola Paulista de Medicina/Universidade Federal de São Paulo - UNIFESP , São Paulo, Brazil
| | | | | | - Silvio Vega
- Complejo Hospitalario Metropolitano , Ciudad de Panamá, Panama
| | - Duilio Nuñez
- Infectious Diseases División, IPS Hospital Central , Asunción, Paraguay
| | - Luis Cuellar
- Servicio de Infectologia, Instituto Nacional de Enfermedades Neoplasicas , Lima, Peru
| | | | - Paulo F Castañeda-Méndez
- Department of Infectious Diseases, Hospital San Angel Inn Universidad , Ciudad de México, Mexico
| | | | - María Virginia Villegas
- Grupo de Resistencia Antimicrobiana y Epidemiología Hospitalaria, Universidad El Bosque . Bogotá, Colombia.,Centro Médico Imbanaco . Cali, Colombia
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Ortiz-Brizuela E, Caro-Vega Y, Bobadilla-Del-Valle M, Leal-Vega F, Criollo-Mora E, López Luis BA, Esteban-Kenel V, Torres-Veintimilla E, Galindo-Fraga A, Olivas-Martínez A, Tovar-Calderón E, Torres-González P, Sifuentes-Osornio J, Ponce-de-León A. The influence of hospital antimicrobial use on carbapenem-non-susceptible Enterobacterales incidence rates according to their mechanism of resistance: a time-series analysis. J Hosp Infect 2020; 105:757-765. [PMID: 32565368 DOI: 10.1016/j.jhin.2020.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/10/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Carbapenem non-susceptible Enterobacterales (CNSE) can be broadly divided into those that produce carbapenemases (carbapenemase-producing Enterobacterales (CPE)), and those that harbour other mechanisms of resistance (non-carbapenemase-producing CNSE (NCP-CNSE)). AIM To determine the predictors of CNSE nosocomial incidence rates according to their mechanism of resistance. METHODS A time-series analysis was conducted (July 2013 to December 2018) to evaluate the relationship in time between hospital antibiotic use and the percentage of adherence to hand hygiene with the CNSE rates. FINDINGS In all, 20,641 non-duplicated Enterobacterales isolates were identified; 2.2% were CNSE. Of these, 48.1% and 51.9% were CPE and NCP-CNSE, respectively. Of the CPE, 78.3% possessed a blaOXA-232 gene. A transfer function model was identified for CNSE, CPE, and OXA-232 CPE that explained 20.8%, 19.3%, and 24.2% of their variation, respectively. According to the CNSE and CPE models, an increase in piperacillin-tazobactam (TZP) use of 1 defined daily dose (DDD) per 100 hospital patient-days (HPD) would lead to an increase of 0.69 and 0.49 CNSE and CPE cases per 10,000 HPD, respectively. The OXA-232 CPE model estimates that an increase of 1 DDD per 100 HPD of TZP use would lead to an increase of 0.43 OXA-232 CPE cases per 10,000 HPD. A transfer function model was not identified for NCP-CNSE, nor was there an association between the adherence to handhygiene and the CNSE rates. CONCLUSION The use of TZP is related in time with the CPE nosocomial rates, mostly explained by its effect on OXA-232 CPE.
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Affiliation(s)
- E Ortiz-Brizuela
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Y Caro-Vega
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - M Bobadilla-Del-Valle
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - F Leal-Vega
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Criollo-Mora
- Department of Pharmacy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - B A López Luis
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - V Esteban-Kenel
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Torres-Veintimilla
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A Galindo-Fraga
- Department of Epidemiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A Olivas-Martínez
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - E Tovar-Calderón
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - P Torres-González
- Laboratory of Clinical Microbiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - J Sifuentes-Osornio
- Department of Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - A Ponce-de-León
- Department of Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Schmid A, Wolfensberger A, Nemeth J, Schreiber PW, Sax H, Kuster SP. Monotherapy versus combination therapy for multidrug-resistant Gram-negative infections: Systematic Review and Meta-Analysis. Sci Rep 2019; 9:15290. [PMID: 31664064 PMCID: PMC6821042 DOI: 10.1038/s41598-019-51711-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/07/2019] [Indexed: 01/01/2023] Open
Abstract
Infections caused by carbapenemase-producing, multidrug-resistant (MDR), or extensively drug-resistant (XDR) Gram-negative bacteria constitute a major therapeutic challenge. Whether combination antibiotic therapy is superior to monotherapy remains unknown. In this systematic review and meta-analysis OVID MEDLINE, EMBASE, PubMed, The Cochrane Library, and Scopus databases were searched for randomized controlled trials (RCTs) and observational studies published by December 2016 comparing mono- with combination antibiotic therapy for infections with carbapenemase-producing, MDR, or XDR Gram-negative bacteria. Mortality and clinical cure rates served as primary and secondary outcome measures, respectively. Of 8847 initially identified studies, 53 studies - covering pneumonia (n = 10 studies), blood stream (n = 15), osteoarticular (n = 1), and mixed infections (n = 27) - were included. 41% (n = 1848) of patients underwent monotherapy, and 59% (n = 2666) combination therapy. In case series/cohort studies (n = 45) mortality was lower with combination- vs. monotherapy (RR 0.83, CI 0.73-0.93, p = 0.002, I2 = 24%). Subgroup analysis revealed lower mortality with combination therapy with at least two in-vitro active antibiotics, in blood stream infections, and carbapenemase-producing Enterobacteriaceae. No mortality difference was seen in case-control studies (n = 6) and RCTs (n = 2). Cure rates did not differ regardless of study type. The two included RCTs had a high and unknown risk of bias, respectively. 16.7% (1/6) of case-control studies and 37.8% (17/45) of cases series/cohort studies were of good quality, whereas quality was poor in the remaining studies. In conclusion, combination antimicrobial therapy of multidrug-resistant Gram-negative bacteria appears to be superior to monotherapy with regard to mortality.
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Affiliation(s)
- Adrian Schmid
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Aline Wolfensberger
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Johannes Nemeth
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Peter W Schreiber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Hugo Sax
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Zurich, Zurich, Switzerland.
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Health outcomes attributable to carbapenemase-producing Enterobacteriaceae infections: A systematic review and meta-analysis. Infect Control Hosp Epidemiol 2019; 41:37-43. [PMID: 31637986 DOI: 10.1017/ice.2019.282] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant global health threat. OBJECTIVE To conduct a systematic review of health outcomes and long-term sequelae attributable to CPE infection. METHODS We followed PRISMA reporting guidelines and published our review protocol on PROSPERO (CRD42018097357). We searched Medline, Embase, CINAHL and the Cochrane Library. We included primary studies with a carbapenem-susceptible control group in high-income countries, published in English. Quality appraisal was completed using Joanna Briggs Institute checklists. We qualitatively summarized frequently reported outcomes and conducted a meta-analysis. RESULTS Our systematic review identified 8,671 studies; 17 met the eligibility criteria for inclusion. All studies reported health outcomes; none reported health-related quality-of-life. Most studies were from Europe (65%), were conducted in teaching or university-affiliated hospitals (76%), and used case-control designs (53%). Mortality was the most commonly reported consequence of CPE-infections; in-hospital mortality was most often reported (62%). Our meta-analysis (n = 5 studies) estimated an absolute risk difference (ARD) for in-hospital bloodstream infection mortality of 0.25 (95% confidence interval [CI], 0.17-0.32). Duration of antibiotic therapy (range, 4-29.7 vs 1-23.6 days) and length of hospital stay (range, 21-87 vs 15-43 days) were relatively higher for CPE-infected patients than for patients infected with carbapenem-susceptible pathogens. Most studies (82%) met >80% of their respective quality appraisal criteria. CONCLUSIONS The risk of in-hospital mortality due to CPE bloodstream infection is considerably greater than carbapenem-susceptible bloodstream infection (ARD, 0.25; 95% CI, 0.17-0.32). Health outcome studies associated with CPE infection are focused on short-term (eg, in-hospital) outcomes; long-term sequelae and quality-of-life are not well studied. TRIAL REGISTRATION PROSPERO (CRD42018097357).
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Arreola-Guerra JM, Rosado-Canto R, Alberú J, Maravilla E, Torres-González P, Criollo E, Pérez M, Mancilla E, Arvizu M, Morales-Buenrostro LE, Vilatobá-Chapa M, Sifuentes-Osornio J. Fosfomycin trometamol in the prophylaxis of post-kidney transplant urinary tract infection: A controlled, randomized clinical trial. Transpl Infect Dis 2018; 20:e12980. [DOI: 10.1111/tid.12980] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- José M. Arreola-Guerra
- Department of Medicine; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Rodrigo Rosado-Canto
- Department of Medicine; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Josefina Alberú
- Department of Transplantation; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Ernesto Maravilla
- Laboratory of Clinical Microbiology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Pedro Torres-González
- Laboratory of Clinical Microbiology; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Elia Criollo
- Department of Pharmacy; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Maria Pérez
- Instituto Nacional de Cardiología Ignacio Chávez; Tlalpan México
| | - Eduardo Mancilla
- Instituto Nacional de Cardiología Ignacio Chávez; Tlalpan México
| | - Mauricio Arvizu
- Department of Nephrology-Mineral Metabolism; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Luis Eduardo Morales-Buenrostro
- Department of Nephrology-Mineral Metabolism; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - Mario Vilatobá-Chapa
- Department of Transplantation; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
| | - José Sifuentes-Osornio
- Department of Medicine; Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán; Tlalpan México
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Aquino-Andrade A, Merida-Vieyra J, Arias de la Garza E, Arzate-Barbosa P, De Colsa Ranero A. Carbapenemase-producing Enterobacteriaceae in Mexico: report of seven non-clonal cases in a pediatric hospital. BMC Microbiol 2018; 18:38. [PMID: 29673319 PMCID: PMC5907697 DOI: 10.1186/s12866-018-1166-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 03/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background Carbapenemases-producing Enterobacteriaceae (CPE) are a worldwide public health emergency. In Mexico, reports of CPE are limited, particularly in the pediatric population. Here, we describe the clinical, epidemiological, and molecular characteristics of seven consecutive cases in a third-level pediatric hospital in Mexico City over a four-month period during 2016. Results The Enterobacteriaceae identified were three Escherichia coli strains (producing OXA-232, NDM-1 and KPC-2), two Klebsiella pneumoniae strains (producing KPC-2 and NDM-1), one Klebsiella oxytoca strain producing OXA-48 and one Enterobacter cloacae strain producing NDM-1. The majority of patients had underlying disesases, three were immunocompromised, and three had infections involved the skin and soft tissues. Half patients died as a result of CPE infection. Conclusions This study represents the first report of E. coli ST131-O25b clone producing NDM-1 in Latin America. In addition, this study is the first finding of K. oxytoca producing OXA-48 and E. coli producing OXA-232 in Mexican pediatric patients.
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Affiliation(s)
- Alejandra Aquino-Andrade
- Molecular Microbiology Laboratory, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Insurgentes Cuicuilco, ZC, 04530, Coyoacán Mexico City, Mexico
| | - Jocelin Merida-Vieyra
- Molecular Microbiology Laboratory, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Insurgentes Cuicuilco, ZC, 04530, Coyoacán Mexico City, Mexico
| | | | | | - Agustín De Colsa Ranero
- Molecular Microbiology Laboratory, Instituto Nacional de Pediatría, Insurgentes Sur 3700-C, Insurgentes Cuicuilco, ZC, 04530, Coyoacán Mexico City, Mexico. .,Pediatric Infectious Disease Department, Instituto Nacional de Pediatria, Mexico City, Mexico.
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