A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba
(1) Background: The spread of carbapenem-resistant <i>Enterobacterales</i> in hospitals constitutes an important epidemiological and therapeutic problem that especially affects vulnerable patients such as perioperative patients. (2) Methods: We conducted a descriptive, observational, ret...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-07-01
|
| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/7/942 |
| _version_ | 1827619224476975104 |
|---|---|
| author | Haiyang Yu Alberto Hernández González Gonzalo Estévez Torres María Karla González Molina Marcia Hart Casares Xu Han Waldemar Baldoquín Rodríguez Dianelys Quiñones Pérez |
| author_facet | Haiyang Yu Alberto Hernández González Gonzalo Estévez Torres María Karla González Molina Marcia Hart Casares Xu Han Waldemar Baldoquín Rodríguez Dianelys Quiñones Pérez |
| author_sort | Haiyang Yu |
| collection | DOAJ |
| description | (1) Background: The spread of carbapenem-resistant <i>Enterobacterales</i> in hospitals constitutes an important epidemiological and therapeutic problem that especially affects vulnerable patients such as perioperative patients. (2) Methods: We conducted a descriptive, observational, retrospective case-control study of patients infected with carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) and carbapenem-susceptible Enterobacterales during the perioperative period in a tertiary hospital. (3) Results: Metallo-β-lactamase was detected in all 124 CRE isolates, with NDM-type carbapenemase being dominant, while 3 isolates coproduced KPC-type enzyme and showed high resistance rates against all antibiotics except colistin (25.2%). By analyzing the risk factors for infection, steroid use (OR: 3.22, <i>p</i> < 0.01), prior use of two or more antibiotics (OR: 4.04, <i>p</i> = 0.01), prior use of broad-spectrum cephalosporins (OR: 2.40, <i>p</i> = 0.04), and prior use of carbapenem (OR: 4.77, <i>p</i> = 0.03) were found to be independent risk factors for CP-CRE infection. In addition, in this study, we observed that the clinical outcomes of bloodstream infections and pneumonia associated with CP-CRE posed higher mortality risks. However, by analyzing the associations between treatment options and mortality, it was found that, in bloodstream infections caused by CP-CRE, colistin-based regimens showed a significant advantage (PR = 0.40, <i>p</i> = 0.03). (4) Conclusions: High mortality is associated with nosocomial infections in the perioperative period caused by carbapenemase-producing Enterobacterales, the dissemination of which in health care settings in Cuba remains a public health challenge. |
| first_indexed | 2024-03-09T10:24:13Z |
| format | Article |
| id | doaj.art-6903aa719fc04af19913caf643ad058d |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T10:24:13Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-6903aa719fc04af19913caf643ad058d2023-12-01T21:49:07ZengMDPI AGAntibiotics2079-63822022-07-0111794210.3390/antibiotics11070942A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, CubaHaiyang Yu0Alberto Hernández González1Gonzalo Estévez Torres2María Karla González Molina3Marcia Hart Casares4Xu Han5Waldemar Baldoquín Rodríguez6Dianelys Quiñones Pérez7Pedro Kourí Institute of Tropical Medicine, Havana 11400, CubaHermanos Ameijeiras Hospital, Havana 10400, CubaHermanos Ameijeiras Hospital, Havana 10400, CubaPedro Kourí Institute of Tropical Medicine, Havana 11400, CubaHermanos Ameijeiras Hospital, Havana 10400, CubaPedro Kourí Institute of Tropical Medicine, Havana 11400, CubaPedro Kourí Institute of Tropical Medicine, Havana 11400, CubaPedro Kourí Institute of Tropical Medicine, Havana 11400, Cuba(1) Background: The spread of carbapenem-resistant <i>Enterobacterales</i> in hospitals constitutes an important epidemiological and therapeutic problem that especially affects vulnerable patients such as perioperative patients. (2) Methods: We conducted a descriptive, observational, retrospective case-control study of patients infected with carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) and carbapenem-susceptible Enterobacterales during the perioperative period in a tertiary hospital. (3) Results: Metallo-β-lactamase was detected in all 124 CRE isolates, with NDM-type carbapenemase being dominant, while 3 isolates coproduced KPC-type enzyme and showed high resistance rates against all antibiotics except colistin (25.2%). By analyzing the risk factors for infection, steroid use (OR: 3.22, <i>p</i> < 0.01), prior use of two or more antibiotics (OR: 4.04, <i>p</i> = 0.01), prior use of broad-spectrum cephalosporins (OR: 2.40, <i>p</i> = 0.04), and prior use of carbapenem (OR: 4.77, <i>p</i> = 0.03) were found to be independent risk factors for CP-CRE infection. In addition, in this study, we observed that the clinical outcomes of bloodstream infections and pneumonia associated with CP-CRE posed higher mortality risks. However, by analyzing the associations between treatment options and mortality, it was found that, in bloodstream infections caused by CP-CRE, colistin-based regimens showed a significant advantage (PR = 0.40, <i>p</i> = 0.03). (4) Conclusions: High mortality is associated with nosocomial infections in the perioperative period caused by carbapenemase-producing Enterobacterales, the dissemination of which in health care settings in Cuba remains a public health challenge.https://www.mdpi.com/2079-6382/11/7/942carbapenemase<i>Enterobacterales</i>CubaNDMrisk factormortality |
| spellingShingle | Haiyang Yu Alberto Hernández González Gonzalo Estévez Torres María Karla González Molina Marcia Hart Casares Xu Han Waldemar Baldoquín Rodríguez Dianelys Quiñones Pérez A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba Antibiotics carbapenemase <i>Enterobacterales</i> Cuba NDM risk factor mortality |
| title | A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba |
| title_full | A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba |
| title_fullStr | A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba |
| title_full_unstemmed | A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba |
| title_short | A Retrospective Study of Risk Factors, Mortality, and Treatment Outcomes for Infections with Carbapenemase-Producing <i>Enterobacterales</i> in a Tertiary Hospital in Havana, Cuba |
| title_sort | retrospective study of risk factors mortality and treatment outcomes for infections with carbapenemase producing i enterobacterales i in a tertiary hospital in havana cuba |
| topic | carbapenemase <i>Enterobacterales</i> Cuba NDM risk factor mortality |
| url | https://www.mdpi.com/2079-6382/11/7/942 |
| work_keys_str_mv | AT haiyangyu aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT albertohernandezgonzalez aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT gonzaloesteveztorres aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT mariakarlagonzalezmolina aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT marciahartcasares aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT xuhan aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT waldemarbaldoquinrodriguez aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT dianelysquinonesperez aretrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT haiyangyu retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT albertohernandezgonzalez retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT gonzaloesteveztorres retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT mariakarlagonzalezmolina retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT marciahartcasares retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT xuhan retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT waldemarbaldoquinrodriguez retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba AT dianelysquinonesperez retrospectivestudyofriskfactorsmortalityandtreatmentoutcomesforinfectionswithcarbapenemaseproducingienterobacteralesiinatertiaryhospitalinhavanacuba |