Characterization and clinical impact of bloodstream infection caused by carbapenemase-producing enterobacteriaceae in seven Latin American countries

Villegas, Maria Virginia; Pallares, Christian J.; Escandón-Vargas, Kevin; Hernández-Gómez, Cristhian; Correa, Adriana; Álvarez Moreno, Carlos Arturo; Rosso, Fernando; Matta, Lorena; Luna, Carlos; Zurita, Jeannete; Mejía-Villatoro, Carlos; Rodríguez-Noriega, Eduardo; Seas, Carlos; Cortesía, Manuel; Guzmán-Suárez, Alfonso; Guzmán-Blanco, Manuel

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dc.rights.licence	Atribución-NoComercial 4.0 Internacional	*
dc.contributor.author	Villegas, Maria Virginia
dc.contributor.author	Pallares, Christian J.
dc.contributor.author	Escandón-Vargas, Kevin
dc.contributor.author	Hernández-Gómez, Cristhian
dc.contributor.author	Correa, Adriana
dc.contributor.author	Álvarez Moreno, Carlos Arturo
dc.contributor.author	Rosso, Fernando
dc.contributor.author	Matta, Lorena
dc.contributor.author	Luna, Carlos
dc.contributor.author	Zurita, Jeannete
dc.contributor.author	Mejía-Villatoro, Carlos
dc.contributor.author	Rodríguez-Noriega, Eduardo
dc.contributor.author	Seas, Carlos
dc.contributor.author	Cortesía, Manuel
dc.contributor.author	Guzmán-Suárez, Alfonso
dc.contributor.author	Guzmán-Blanco, Manuel
dc.date.accessioned	2020-09-01T21:28:23Z
dc.date.available	2020-09-01T21:28:23Z
dc.date.created	2016
dc.identifier	https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0154092&type=printable	spa
dc.identifier.issn	1932-6203 (Electrónico)	spa
dc.identifier.uri	http://hdl.handle.net/10554/50939
dc.format	PDF	spa
dc.format.mimetype	application/pdf	spa
dc.language	Inglés	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc/4.0/	*
dc.source	PloS One; Vol. 11 Núm. 4 (2016)	spa
dc.title	Characterization and clinical impact of bloodstream infection caused by carbapenemase-producing enterobacteriaceae in seven Latin American countries	spa
dc.type	info:eu-repo/semantics/article
dc.type.hasversion	http://purl.org/coar/version/c_ab4af688f83e57aa
dc.description.quartilewos	Q2	spa
dc.description.quartilescopus	Q1	spa
dc.identifier.doi	https://doi.org/10.1371/journal.pone.0154092	spa
dc.description.paginas	e0154092	spa
dc.format.soporte	Electrónico	spa
dc.description.abstractenglish	Introduction: Infections caused by carbapenem-resistant Enterobacteriaceae are a public health problem associated with higher mortality rates, longer hospitalization and increased healthcare costs. We carried out a study to describe the characteristics of patients with carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE bloodstream infection (BSI) from Latin American hospitals and to determine the clinical impact in terms of mortality and antibiotic therapy. Methods: Between July 2013 and November 2014, we conducted a multicenter observational study in 11 hospitals from 7 Latin American countries (Argentina, Colombia, Ecuador, Guatemala, Mexico, Peru, Venezuela). Patients with BSI caused by Enterobacteriaceae were included and classified either as CPE or non-CPE based on detection of blaKPC, blaVIM, blaIMP, blaNDM and blaOXA-48 by polymerase chain reaction. Enrolled subjects were followed until discharge or death. Demographic, microbiological and clinical characteristics were collected from medical records. Both descriptive and inferential statistics were used to analyze the information. Results: A total of 255 patients with Enterobacteriaceae BSI were included; CPE were identified in 53 of them. In vitro non-susceptibility to all screened antibiotics was higher in the patients with CPE BSI, remaining colistin, tigecycline and amikacin as the most active drugs. Combination therapy was significantly more frequent in the CPE BSI group (p < 0.001). The most common regimen was carbapenem + colistin or polymyxin B. The overall mortality was 37% (94/255). Overall and attributable mortality were significantly higher in patients with CPE BSI (p < 0.001); however, we found that patients with CPE BSI who received combination therapy and those who received monotherapy had similar mortality. After multivariate adjustment, CPE BSI (adjusted odds ratio [aOR] 4; 95% confidence interval [CI] 1.7-9.5; p = 0.002) and critical illness (aOR 6.5; 95% CI 3.1-13.7; p < 0.001) were independently associated with in-hospital mortality. Conclusions: This study provides valuable data on the clinical characteristics and mortality risk factors in patients with CPE BSI. We determined that CPE infection is an independent mortality predictor and thus Latin American hospitals should perform campaigns on prevention and control of CPE BSI.	spa
dc.type.local	Artículo de revista	spa
dc.contributor.corporatename	Pontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Grupo de Investigación en Enfermedades Infecciosas HUSI - PUJ