Clinical Significance of Community- and Healthcare-Acquired Carbapenem-Resistant Enterobacteriaceae Isolates

doi:10.1371/journal.pone.0151897

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Title:	Clinical Significance of Community- and Healthcare-Acquired Carbapenem-Resistant Enterobacteriaceae Isolates
Authors:	Tang, Hung-Jen Hsieh, Cheng-Fang Chang, Ping-Chin Chen, Jyh-Jou Lin, Yu-Hsiu Lai, Chih-Cheng Chao, Chien-Ming Chuang, Yin-Ching
Contributors:	Chi Mei Med Ctr, Dept Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Geriatr & Gerontol Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Neurol Chi Mei Med Ctr, Dept Internal Med Chi Mei Med Ctr, Comm Infect Control Chi Mei Med Ctr, Dept Intens Care Med Min Hwei Coll Hlth Care Management, Dept Nursing Chi Mei Med Ctr, Dept Med Res
Keywords:	nonsusceptible klebsiella-pneumoniae escherichia-coli united-states risk-factors epidemiology taiwan infections multicenter bacteremia prevention
Date:	2016-03
Issue Date:	2018-01-18 11:41:20 (UTC+8)
Publisher:	Public Library Science
Abstract:	This study was conducted to investigate the clinical significance, manifestations, microbiological characteristics and outcomes of carbapenem-resistant Enterobacteriaceae (wCRE) isolates, and compare the clinical features of community-and healthcare-acquired CRE isolates. A total of 78 patients were identified to have CRE. Klebsiella pneumoniae was the most common pathogens (n = 42, 53.8%), followed by Enterobacter cloacae (n = 24, 30.8%), and Escherichia coli (n = 11, 14.1%). Most of the patients acquired CRE from healthcare settings (n = 55, 70.5%), and other cases got CRE from community settings (n = 23, 29.5%). Nine cases (11.5%) were classified as CRE colonization. Among the remaining 69 cases of CRE infections, pneumonia (n = 28, 40.6%) was the most common type of infections, followed by urinary tract infection (n = 24, 34.8%), and intra-abdominal infection (n = 16, 23.2%). The patients acquired CRE from community settings were more likely to be elderly, female, and had more urinary tract infections than from healthcare settings. In contrast, the patients acquired CRE from healthcare settings had more intra-abdominal infections, intra-abdominal surgery, and presence of indwelling device than from community settings. In conclusion, community-acquired CRE are not rare, and their associated clinical presentations are different from healthcare-acquired CRE.
Relation:	Plos One, v.11 n.3, e0151897
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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