Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain

Zaira R. Palacios-Baena; Jesús Oteo; Carmen Conejo; M. Nieves Larrosa; Germán Bou; Marta Fernández-Martínez; Juan José González-López; Vicente Pintado; Luis Martínez-Martínez; María Merino; Virginia Pomar; Marta Mora-Rillo; María Alba Rivera; Antonio Oliver; Guillermo Ruiz-Carrascoso; Patricia Ruiz-Garbajosa; Laura Zamorano; Verónica Bautista; Adriana Ortega; Isabel Morales; Álvaro Pascual; José Campos; Jesús Rodríguez-Baño; Ángel Zaballos; Rafael Cantón; Laura Martínez-García; Ana María Fleites; Carlos Rodríguez-Lucas; Ma Isabel Sánchez-Romero; Luisa García-Picazo; Esteban Aznar; Carolina Campelo; Alejandro González-Praetorius; Sonia Solís; Salvador Giner; Miguel Salavert; Juan Manuel Hernández; Josep Vilaró Pujals; Anna Vilamala Bastarras; Ma Ángeles Orellana; Emilia Cercenado; Mateu Espasa; Dionisia Fontanals; Ma Victoria García-López; José Luis Hernández-Almaraz; Carmina Martí-Sala; Adelina Gimeno; Teresa Alarcón; Laura Llorca; Concepción Segura; Raquel Clivillé-Abad; Montse Motjé; Delia Garcia i Parés; Pedro de laIglesia; Beatriz Iglesias; Juanjo Castón; María Dolores Romero; José Antonio Rodríguez-Polo; Gloria Trujillo; Montserrat Morta; Alberto Gil Setas; Carmen Ezpeleta; Ma Dolores Miguel-Martínez; Antonio Sánchez-Porto; Javier Casas; David Molina; Eugenio Garduño; Juan Carlos Alados; Pepa Pérez-Jové; Goretti Sauca; Carmen Gallés; Fátima Galánand; Francisca Guerrero; Ma Fe Brezmes; Ma Pilar Ortega; Francisco Javier Castillo; Cristina Seral; Alberto Delgado-Iribarren; Alberto Yagüe; Carmen Aspiroz; Ma Isabel Fernández-Natal; Isabel Wilhelmi; Pilar Reyes; Ma Dolores Pérez-Ramírez; Inocente Cuesta; Mar Olga Pérez Moreno; Amparo García; Frederic Ballester; Isabel Pujol; Montserrat Sierra; Araceli González-Cuevas; Pilar López García; Lluís Carbó Saladrigas; Jesús Martínez-López; null Lucía Martí-nez-Lamas; Jorge Julio Cabrera; null Susana García de Cruz; Carmen Raya; Ana Belén Campo; Inés de Benito

doi:10.1016/j.jinf.2015.10.008

Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain

Zaira R. Palacios-Baena, Jesús Oteo, Carmen Conejo, M. Nieves Larrosa, Germán Bou, Marta Fernández-Martínez, Juan José González-López, Vicente Pintado, Luis Martínez-Martínez, María Merino, Virginia Pomar, Marta Mora-Rillo, María Alba Rivera, Antonio Oliver, Guillermo Ruiz-Carrascoso, Patricia Ruiz-Garbajosa, Laura Zamorano, Verónica Bautista, Adriana Ortega, Isabel MoralesÁlvaro Pascual, José Campos, Jesús Rodríguez-Baño, Ángel Zaballos, Rafael Cantón, Laura Martínez-García, Ana María Fleites, Carlos Rodríguez-Lucas, Ma Isabel Sánchez-Romero, Luisa García-Picazo, Esteban Aznar, Carolina Campelo, Alejandro González-Praetorius, Sonia Solís, Salvador Giner, Miguel Salavert, Juan Manuel Hernández, Josep Vilaró Pujals, Anna Vilamala Bastarras, Ma Ángeles Orellana, Emilia Cercenado, Mateu Espasa, Dionisia Fontanals, Ma Victoria García-López, José Luis Hernández-Almaraz, Carmina Martí-Sala, Adelina Gimeno, Teresa Alarcón, Laura Llorca, Concepción Segura, Raquel Clivillé-Abad, Montse Motjé, Delia Garcia i Parés, Pedro de laIglesia, Beatriz Iglesias, Juanjo Castón, María Dolores Romero, José Antonio Rodríguez-Polo, Gloria Trujillo, Montserrat Morta, Alberto Gil Setas, Carmen Ezpeleta, Ma Dolores Miguel-Martínez, Antonio Sánchez-Porto, Javier Casas, David Molina, Eugenio Garduño, Juan Carlos Alados, Pepa Pérez-Jové, Goretti Sauca, Carmen Gallés, Fátima Galánand, Francisca Guerrero, Ma Fe Brezmes, Ma Pilar Ortega, Francisco Javier Castillo, Cristina Seral, Alberto Delgado-Iribarren, Alberto Yagüe, Carmen Aspiroz, Ma Isabel Fernández-Natal, Isabel Wilhelmi, Pilar Reyes, Ma Dolores Pérez-Ramírez, Inocente Cuesta, Mar Olga Pérez Moreno, Amparo García, Frederic Ballester, Isabel Pujol, Montserrat Sierra, Araceli González-Cuevas, Pilar López García, Lluís Carbó Saladrigas, Jesús Martínez-López, Lucía Martí-nez-Lamas, Jorge Julio Cabrera, Susana García de Cruz, Carmen Raya, Ana Belén Campo, Inés de Benito

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© 2015 The British Infection Association. Background: Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. Methods: A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Results: Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-β-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare-associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). Conclusions: We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality.

Idioma original	Anglès
Pàgines (de-a)	152-160
Revista	Journal of Infection
Volum	72
Número	2
DOIs	https://doi.org/10.1016/j.jinf.2015.10.008
Estat de la publicació	Publicada - 1 de febr. 2016

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10.1016/j.jinf.2015.10.008

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Palacios-Baena, Z. R., Oteo, J., Conejo, C., Larrosa, M. N., Bou, G., Fernández-Martínez, M., González-López, J. J., Pintado, V., Martínez-Martínez, L., Merino, M., Pomar, V., Mora-Rillo, M., Rivera, M. A., Oliver, A., Ruiz-Carrascoso, G., Ruiz-Garbajosa, P., Zamorano, L., Bautista, V., Ortega, A., ... de Benito, I. (2016). Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain. Journal of Infection, 72(2), 152-160. https://doi.org/10.1016/j.jinf.2015.10.008

@article{647b163e79754f35ab28cbfed4d65bd2,

title = "Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain",

abstract = "{\textcopyright} 2015 The British Infection Association. Background: Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. Methods: A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Results: Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-β-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare-associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). Conclusions: We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality.",

keywords = "Carbapenem resistant Enterobacteriaceae, Clinical features, Geographic distribution, Risk factors",

author = "Palacios-Baena, {Zaira R.} and Jes{\'u}s Oteo and Carmen Conejo and Larrosa, {M. Nieves} and Germ{\'a}n Bou and Marta Fern{\'a}ndez-Mart{\'i}nez and Gonz{\'a}lez-L{\'o}pez, {Juan Jos{\'e}} and Vicente Pintado and Luis Mart{\'i}nez-Mart{\'i}nez and Mar{\'i}a Merino and Virginia Pomar and Marta Mora-Rillo and Rivera, {Mar{\'i}a Alba} and Antonio Oliver and Guillermo Ruiz-Carrascoso and Patricia Ruiz-Garbajosa and Laura Zamorano and Ver{\'o}nica Bautista and Adriana Ortega and Isabel Morales and {\'A}lvaro Pascual and Jos{\'e} Campos and Jes{\'u}s Rodr{\'i}guez-Ba{\~n}o and {\'A}ngel Zaballos and Rafael Cant{\'o}n and Laura Mart{\'i}nez-Garc{\'i}a and Fleites, {Ana Mar{\'i}a} and Carlos Rodr{\'i}guez-Lucas and S{\'a}nchez-Romero, {Ma Isabel} and Luisa Garc{\'i}a-Picazo and Esteban Aznar and Carolina Campelo and Alejandro Gonz{\'a}lez-Praetorius and Sonia Sol{\'i}s and Salvador Giner and Miguel Salavert and Hern{\'a}ndez, {Juan Manuel} and Pujals, {Josep Vilar{\'o}} and Bastarras, {Anna Vilamala} and Orellana, {Ma {\'A}ngeles} and Emilia Cercenado and Mateu Espasa and Dionisia Fontanals and Garc{\'i}a-L{\'o}pez, {Ma Victoria} and Hern{\'a}ndez-Almaraz, {Jos{\'e} Luis} and Carmina Mart{\'i}-Sala and Adelina Gimeno and Teresa Alarc{\'o}n and Laura Llorca and Concepci{\'o}n Segura and Raquel Clivill{\'e}-Abad and Montse Motj{\'e} and {Garcia i Par{\'e}s}, Delia and {de laIglesia}, Pedro and Beatriz Iglesias and Juanjo Cast{\'o}n and Romero, {Mar{\'i}a Dolores} and Rodr{\'i}guez-Polo, {Jos{\'e} Antonio} and Gloria Trujillo and Montserrat Morta and Setas, {Alberto Gil} and Carmen Ezpeleta and Miguel-Mart{\'i}nez, {Ma Dolores} and Antonio S{\'a}nchez-Porto and Javier Casas and David Molina and Eugenio Gardu{\~n}o and Alados, {Juan Carlos} and Pepa P{\'e}rez-Jov{\'e} and Goretti Sauca and Carmen Gall{\'e}s and F{\'a}tima Gal{\'a}nand and Francisca Guerrero and Brezmes, {Ma Fe} and Ortega, {Ma Pilar} and Castillo, {Francisco Javier} and Cristina Seral and Alberto Delgado-Iribarren and Alberto Yag{\"u}e and Carmen Aspiroz and Fern{\'a}ndez-Natal, {Ma Isabel} and Isabel Wilhelmi and Pilar Reyes and P{\'e}rez-Ram{\'i}rez, {Ma Dolores} and Inocente Cuesta and {P{\'e}rez Moreno}, {Mar Olga} and Amparo Garc{\'i}a and Frederic Ballester and Isabel Pujol and Montserrat Sierra and Araceli Gonz{\'a}lez-Cuevas and Garc{\'i}a, {Pilar L{\'o}pez} and Saladrigas, {Llu{\'i}s Carb{\'o}} and Jes{\'u}s Mart{\'i}nez-L{\'o}pez and {Luc{\'i}a Mart{\'i}-nez-Lamas} and Cabrera, {Jorge Julio} and {Susana Garc{\'i}a de Cruz} and Carmen Raya and Campo, {Ana Bel{\'e}n} and {de Benito}, In{\'e}s",

year = "2016",

month = feb,

day = "1",

doi = "10.1016/j.jinf.2015.10.008",

language = "English",

volume = "72",

pages = "152--160",

journal = "Journal of Infection",

issn = "0163-4453",

publisher = "W.B. Saunders Ltd",

number = "2",

}

Palacios-Baena, ZR, Oteo, J, Conejo, C, Larrosa, MN, Bou, G, Fernández-Martínez, M, González-López, JJ, Pintado, V, Martínez-Martínez, L, Merino, M, Pomar, V, Mora-Rillo, M, Rivera, MA, Oliver, A, Ruiz-Carrascoso, G, Ruiz-Garbajosa, P, Zamorano, L, Bautista, V, Ortega, A, Morales, I, Pascual, Á, Campos, J, Rodríguez-Baño, J, Zaballos, Á, Cantón, R, Martínez-García, L, Fleites, AM, Rodríguez-Lucas, C, Sánchez-Romero, MI, García-Picazo, L, Aznar, E, Campelo, C, González-Praetorius, A, Solís, S, Giner, S, Salavert, M, Hernández, JM, Pujals, JV, Bastarras, AV, Orellana, MÁ, Cercenado, E, Espasa, M, Fontanals, D, García-López, MV, Hernández-Almaraz, JL, Martí-Sala, C, Gimeno, A, Alarcón, T, Llorca, L, Segura, C, Clivillé-Abad, R, Motjé, M, Garcia i Parés, D, de laIglesia, P, Iglesias, B, Castón, J, Romero, MD, Rodríguez-Polo, JA, Trujillo, G, Morta, M, Setas, AG, Ezpeleta, C, Miguel-Martínez, MD, Sánchez-Porto, A, Casas, J, Molina, D, Garduño, E, Alados, JC, Pérez-Jové, P, Sauca, G, Gallés, C, Galánand, F, Guerrero, F, Brezmes, MF, Ortega, MP, Castillo, FJ, Seral, C, Delgado-Iribarren, A, Yagüe, A, Aspiroz, C, Fernández-Natal, MI, Wilhelmi, I, Reyes, P, Pérez-Ramírez, MD, Cuesta, I, Pérez Moreno, MO, García, A, Ballester, F, Pujol, I, Sierra, M, González-Cuevas, A, García, PL, Saladrigas, LC, Martínez-López, J, Lucía Martí-nez-Lamas, Cabrera, JJ, Susana García de Cruz, Raya, C, Campo, AB & de Benito, I 2016, 'Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain', Journal of Infection, vol. 72, núm. 2, pàg. 152-160. https://doi.org/10.1016/j.jinf.2015.10.008

Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain. / Palacios-Baena, Zaira R.; Oteo, Jesús; Conejo, Carmen et al.
In: Journal of Infection, Vol. 72, Núm. 2, 01.02.2016, pàg. 152-160.

Producció científica: Contribució a revista › Article › Recerca › Avaluat per experts

TY - JOUR

T1 - Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain

AU - Palacios-Baena, Zaira R.

AU - Oteo, Jesús

AU - Conejo, Carmen

AU - Larrosa, M. Nieves

AU - Bou, Germán

AU - Fernández-Martínez, Marta

AU - González-López, Juan José

AU - Pintado, Vicente

AU - Martínez-Martínez, Luis

AU - Merino, María

AU - Pomar, Virginia

AU - Mora-Rillo, Marta

AU - Rivera, María Alba

AU - Oliver, Antonio

AU - Ruiz-Carrascoso, Guillermo

AU - Ruiz-Garbajosa, Patricia

AU - Zamorano, Laura

AU - Bautista, Verónica

AU - Ortega, Adriana

AU - Morales, Isabel

AU - Pascual, Álvaro

AU - Campos, José

AU - Rodríguez-Baño, Jesús

AU - Zaballos, Ángel

AU - Cantón, Rafael

AU - Martínez-García, Laura

AU - Fleites, Ana María

AU - Rodríguez-Lucas, Carlos

AU - Sánchez-Romero, Ma Isabel

AU - García-Picazo, Luisa

AU - Aznar, Esteban

AU - Campelo, Carolina

AU - González-Praetorius, Alejandro

AU - Solís, Sonia

AU - Giner, Salvador

AU - Salavert, Miguel

AU - Hernández, Juan Manuel

AU - Pujals, Josep Vilaró

AU - Bastarras, Anna Vilamala

AU - Orellana, Ma Ángeles

AU - Cercenado, Emilia

AU - Espasa, Mateu

AU - Fontanals, Dionisia

AU - García-López, Ma Victoria

AU - Hernández-Almaraz, José Luis

AU - Martí-Sala, Carmina

AU - Gimeno, Adelina

AU - Alarcón, Teresa

AU - Llorca, Laura

AU - Segura, Concepción

AU - Clivillé-Abad, Raquel

AU - Motjé, Montse

AU - Garcia i Parés, Delia

AU - de laIglesia, Pedro

AU - Iglesias, Beatriz

AU - Castón, Juanjo

AU - Romero, María Dolores

AU - Rodríguez-Polo, José Antonio

AU - Trujillo, Gloria

AU - Morta, Montserrat

AU - Setas, Alberto Gil

AU - Ezpeleta, Carmen

AU - Miguel-Martínez, Ma Dolores

AU - Sánchez-Porto, Antonio

AU - Casas, Javier

AU - Molina, David

AU - Garduño, Eugenio

AU - Alados, Juan Carlos

AU - Pérez-Jové, Pepa

AU - Sauca, Goretti

AU - Gallés, Carmen

AU - Galánand, Fátima

AU - Guerrero, Francisca

AU - Brezmes, Ma Fe

AU - Ortega, Ma Pilar

AU - Castillo, Francisco Javier

AU - Seral, Cristina

AU - Delgado-Iribarren, Alberto

AU - Yagüe, Alberto

AU - Aspiroz, Carmen

AU - Fernández-Natal, Ma Isabel

AU - Wilhelmi, Isabel

AU - Reyes, Pilar

AU - Pérez-Ramírez, Ma Dolores

AU - Cuesta, Inocente

AU - Pérez Moreno, Mar Olga

AU - García, Amparo

AU - Ballester, Frederic

AU - Pujol, Isabel

AU - Sierra, Montserrat

AU - González-Cuevas, Araceli

AU - García, Pilar López

AU - Saladrigas, Lluís Carbó

AU - Martínez-López, Jesús

AU - Lucía Martí-nez-Lamas, null

AU - Cabrera, Jorge Julio

AU - Susana García de Cruz, null

AU - Raya, Carmen

AU - Campo, Ana Belén

AU - de Benito, Inés

PY - 2016/2/1

Y1 - 2016/2/1

N2 - © 2015 The British Infection Association. Background: Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. Methods: A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Results: Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-β-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare-associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). Conclusions: We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality.

AB - © 2015 The British Infection Association. Background: Most available information on carbapenemase-producing Enterobacteriaceae (CPE) is usually associated with specific types of infection or patient or with descriptions of outbreaks. The aim of this study was to comprehensively analyse the clinical epidemiology, clinical features and outcomes of colonisation and infections due to CPE in Spain. Methods: A multicentre prospective cohort study was carried out in 34 Spanish hospitals from February to May 2013. All new patients testing positive for CPE in clinical samples were included. Logistic regression was used to identify predictors of mortality. Results: Overall, 245 cases were included. The most frequent organism was Klebsiella pneumoniae (74%) and the carbapenemases belonged to the OXA-48 (74%), metallo-β-lactamase (MBL) (24%) and KPC (2%) groups. Acquisition was nosocomial in 145 cases (60%) and healthcare-associated (HCA) in 91 (37%); 42% of the latter were nursing home residents, in whom OXA-48-producing K. pneumoniae ST405 predominated. MBLs and OXA-48 predominated in ICU and medical patients, respectively. Overall, 67% of patients had infections. The most frequent infections identified in this study were urinary tract (43%) and skin structure (21%) infections, and 10% of infections were bacteraemic. Crude mortality was 20%. Inappropriate antibiotic therapy was independently associated with an increased risk of death (OR = 3.30; 95% CI: 1.34-8.11). Conclusions: We found some differences in the epidemiology of CPE depending on the type of carbapenemase produced. Although a low proportion of CPE infections were bacteraemic, active antibiotic therapy was a protective factor for reducing mortality.

KW - Carbapenem resistant Enterobacteriaceae

KW - Clinical features

KW - Geographic distribution

KW - Risk factors

U2 - 10.1016/j.jinf.2015.10.008

DO - 10.1016/j.jinf.2015.10.008

M3 - Article

SN - 0163-4453

VL - 72

SP - 152

EP - 160

JO - Journal of Infection

JF - Journal of Infection

IS - 2

ER -

Comprehensive clinical and epidemiological assessment of colonisation and infection due to carbapenemase-producing Enterobacteriaceae in Spain

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