Carbapenem-Resistant enterobacterales in individuals with and without health care risk factors —Emerging infections program, United States, 2012-2015

Details

• Alternative Title:
  Am J Infect Control
• Personal Author:
  Bulens, Sandra N. ; Reses, Hannah E. ; Ansari, Uzma A. ; Grass, Julian E. ; Carmon, Clayton ; Albrecht, Valerie ; Lawsin, Adrian ; McAllister, Gillian ; Daniels, Jonathan ; Lee, Yeon-Kyeng ; Yi, Sarah ; See, Isaac ; Jacob, Jesse T. ; Bower, Chris W. ; Wilson, Lucy ; Vaeth, Elisabeth ; Lynfield, Ruth ; Vagnone, Paula Snippes ; Shaw, Kristin M. ; Dumyati, Ghinwa ; Tsay, Rebecca ; Phipps, Erin C. ; Bamberg, Wendy ; Janelle, Sarah J. ; Beldavs, Zintars G. ; Cassidy, P. Maureen ; Kainer, Marion ; Muleta, Daniel ; Mounsey, Jacquelyn T. ; Laufer-Halpin, Alison ; Karlsson, Maria ; Lutgring, Joseph D. ; Walters, Maroya Spalding
• Description:
  Background:
  
  Carbapenem-resistant Enterobacterales (CRE) are usually healthcare-associated but are also emerging in the community.
  
  Methods:
  
  Active, population-based surveillance was conducted to identify case-patients with cultures positive for Enterobacterales not susceptible to a carbapenem (excluding ertapenem) and resistant to all third-generation cephalosporins tested at 8 US sites from January 2012 to December 2015. Medical records were used to classify cases as health care-associated, or as community-associated (CA) if a patient had no known health care risk factors and a culture was collected <3 days after hospital admission. Enterobacterales isolates from selected cases were submitted to CDC for whole genome sequencing.
  
  Results:
  
  We identified 1499 CRE cases in 1194 case-patients; 149 cases (10%) in 139 case-patients were CA. The incidence of CRE cases per 100,000 population was 2.96 (95% CI: 2.81, 3.11) overall and 0.29 (95% CI: 0.25, 0.35) for CA-CRE. Most CA-CRE cases were in White persons (73%), females (84%) and identified from urine cultures (98%). Among the 12 sequenced CA-CRE isolates, 5 (42%) harbored a carbapenemase gene.
  
  Conclusions:
  
  Ten percent of CRE cases were CA; some isolates from CA-CRE cases harbored carbapenemase genes. Continued CRE surveillance in the community is critical to monitor emergence outside of traditional health care settings.
• Keywords:
  • Carbapenems
  • Carbapenemase-producing enterobacterales
  • Community-associated disease
  • Healthcare-associated infections
  • Multi-drug resistant gram-negative organisms
  • Female
  • United States
  • Humans
  • Carbapenems
  • Enterobacteriaceae Infections
  More +
• Source:
  Am J Infect Control. 51(1):70-77
• Pubmed ID:
  35909003
• Pubmed Central ID:
  PMC10881240
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  51
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/150311/cdc_150311_DS1.pdf
• File Type:
  [PDF - 383.14 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5285e75d3f419b02d9086f11a8d6fb8845367bd4c873fcd212b699b6e8920b1a