Clinical characteristics and treatment outcomes of carbapenem-resistant Enterobacterales infections in Japan

• DOI: 10.1016/j.jgar.2022.04.004
• Publication Date: 2022-04-13T15:51:40Z
• Authors: Keisuke Oka; Akane Matsumoto; Nobuyuki Tetsuka; Hiroshi Morioka; Mitsutaka Iguchi; Nobuhisa Ishiguro; Tsunehisa Nagamori; Satoshi Takahashi; Norihiro Saito; Koichi Tokuda; Hidetoshi Igari; Yuji Fujikura; Hideaki Kato; Shinichiro Kanai; Fumiko Kusama; Hiromichi Iwasaki; Kazuki Furuhashi; Hisashi Baba; Miki Nagao; Masaki Nakanishi; Kei Kasahara; Hiroshi Kakeya; Hiroki Chikumi; Hiroki Ohge; Momoyo Azuma; Hisamichi Tauchi; Nobuyuki Shimono; Yohei Hamada; Ichiro Takajo; Hirotomo Nakata; Hideki Kawamura; Jiro Fujita; Tetsuya Yagi
• Keywords: Carbapenem; Univariate analysis; Bacteremia

The dissemination of difficult-to-treat carbapenem-resistant Enterobacterales (CRE) is great concern. We clarified the risk factors underlying CRE infection mortality in Japan.We conducted a retrospective, multicentre, observational cohort study patients with infections at 28 university hospitals from September 2014 to December 2016, using Japanese National Surveillance criteria. Clinical information, including patient background, type infection, antibiotic treatment, and treatment outcome, was collected. carbapenemase genotype determined PCR sequencing. Multivariate analysis performed identify for 28-day mortality.Among 179 enrolled, 65 (36.3%) had bloodstream infections, 37 (20.7%) occurring due carbapenemase-producing (CPE); all carbapenemases were IMP-type (IMP-1: 32, IMP-6: 5). Two-thirds CPE identified as Enterobacter cloacae complex. Combination therapy administered only 46 (25.7%), rate 14.3%. Univariate showed that solid metastatic cancer, Charlson Comorbidity Index ≥3, pneumonia, or empyema, central venous catheters, mechanical ventilation, prior use quinolones significant mortality. revealed ventilation (OR: 6.71 [1.42-31.6], P = 0.016), cancers 5.63 [1.38-23.0], 3.49 [1.02-12.0], 0.046) independent mortality.The Japan are cancers, infections.