Carbapenem-resistant Enterobacteriaceae: A retrospective review of treatment and outcomes in a long-term acute care hospital
American Journal of Infection Control Aug 24, 2019
Igbinosa O, Dogho P, Osadiaye N. - By having multiple risk factors for carbapenem-resistant Enterobacteriaceae (CRE) colonization and infection, long-term acute care hospitals (LTACHs) have a unique patient population, so researchers conducted this retrospective analysis of their clinical experience treating CRE infections in an LTACH. CRE infection was reported in 57 cases over the study period (12 cases of bacteremia, 20 cases of health care-associated pneumonia, and 25 cases of complicated urinary tract infection/acute pyelonephritis). Patients with CRE infections had substantial comorbidities, mostly diabetes, heart failure, kidney disease, and solid tumors. Nearly all (56 of 57) patients received empiric antibiotics. A total of 78.9% of patients received monotherapy. Despite great concerns regarding the clinical outcome, a relatively better 28-day mortality and rate of eradication of CRE were noted in this study vs other national estimates, though overall outcome was poor, with a 28-day mortality rate of 17.5% across all infection sites that rose to up to 25% in patients with bacteremia. One of the reasons for overall poor treatment outcomes could be inappropriate empiric treatment.
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