Carbapenem-resistant Enterobacteriaceae (CRE) produce about 13,100 infections each year in the United States, with an 8% death rate. Carbapenemase-producing CRE (CP-CRE) infections have considerably higher mortality rates (40–50%) than other CRE infections. There hasn’t been much research done on the traits that are unique to CP-CRE. For a study, researchers wanted to determine if there were any differences between US veterans with non-CP-CRE cultures and those with CP-CRE cultures. From 2013 through 2018, a retrospective cohort of veterans with CRE cultures was gathered, as well as their demographic, medical, and facility-level variables. Independent factors related to CP-CRE were assessed using clustered multiple logistic regression models. The study comprised 3,096 patients who tested positive for either non-CP-CRE or CP-CRE in their cultures. Being African American (odds ratio: 1.44 [95% CI: 1.15–1.80]), receiving a diagnosis in 2017 (3.11 [2.13–4.54]) or 2018 (3.93 [2.64–5.84]), having congestive heart failure (1.35 [1.11–1.64]), and having gastroesophageal reflux disease (1.39 [1.03–1.87]) were all linked to CP-CRE cultures. 752 patients had no known antibiotic exposure in the prior year (24.3% of the included patients). When compared to those who had known antibiotic exposure, those who had no known antibiotic exposure had a higher rate of chronic proton pump inhibitor use (17.3%). (5.6%). African Americans, patients with congestive heart failure, and those with gastroesophageal reflux illness had higher probabilities of having a CP-CRE culture in a cohort of CRE patients. In the year leading up to their positive culture, almost 1 in 4 patients with CP-CRE had no known antibiotic exposure.

 

Link:academic.oup.com/cid/article/73/8/1370/6273455