ArticleThe Journal of hospital infection2020
Risk factors for Klebsiella pneumoniae carbapenemase (KPC) gene acquisition and clinical outcomes across multiple bacterial species.
Article in The Journal of hospital infection, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 41 citations in OpenAlex.
- Article
- GenusMicroorganisms · 2026Article
- A public health risk model using prior healthcare exposures identifies healthcare-associated pathogen carriage.Infection control and hospital epidemiology · 2026Article
- Biofilm removal in hospital sink drains drives unintended surges in antibiotic resistance.npj antimicrobials and resistance · 2026Article
- Risk Factors and Medical Burden of Multidrug-Resistant Organism Infection in Hospitalized Patients with Pneumonia.Infection and drug resistance · 2026Article
- Cefepime failure for the treatment of cefepime-susceptible, KPC-producingASM case reports · 2025Article
- Study on Antibacterial Activity of Water Extract of Galla chinensis Against Carbapenemase-Producing Enterobacteriaceae.MicrobiologyOpen · 2025Article
- Epidemiological data on the acquisition of carbapenem-resistantAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- [DISTRIBUTION OF CARBAPENEMASES IN TUNISIAN BURN PATIENTS].Annals of burns and fire disasters · 2024Article
- Developing a framework for tracking antimicrobial resistance gene movement in a persistent environmental reservoir.npj antimicrobials and resistance · 2024Article
- Risk factors of carbapenemase-producing Enterobacterales acquisition among adult intensive care unit patients at a Kentucky Academic Medical Center.Infection prevention in practice · 2023Article
- Factors Associated with Extended-Spectrum β-Lactamases and Carbapenem-ResistantPathogens (Basel, Switzerland) · 2023Article
- Detection and Characterization of Carbapenemase-ProducingAntibiotics (Basel, Switzerland) · 2023Article
- Neonatal Bloodstream Infection with Ceftazidime-Avibactam-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Microbial epidemiology and clinical risk factors of carbapenemase-producing Enterobacterales amongst Irish patients from first detection in 2009 until 2020.Infection prevention in practice · 2022Article
- Panorama of Bacterial Infections Caused by Epidemic Resistant Strains.Current microbiology · 2022Review
- The Clinical Manifestation of SARS-CoV-2 in Critically Ill Patients withDiagnostics (Basel, Switzerland) · 2022Article
- Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2021Article
- Long-Term Carbapenems Antimicrobial Stewardship Program.Antibiotics (Basel, Switzerland) · 2020Article
- Carbapenemase-producing Enterobacterales outbreak: Another dark side of COVID-19.American journal of infection control · 2020Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRisk factors for carbapenemase-producing Enterobacterales (CPE) acquisition/infection and associated clinical outcomes have been evaluated in the context of clonal, species-specific outbreaks. Equivalent analyses for complex, multi-species outbreaks, which are increasingly common, are lacking.
methodsBetween December 2010 and January 2017, a case-control study of Klebsiella pneumoniae carbapenemase (KPC)-producing organism (KPCO) acquisition was undertaken using electronic health records from inpatients in a US academic medical centre and long-term acute care hospital (LTACH) with ongoing multi-species KPCO transmission despite a robust CPE screening programme. Cases had a first KPCO-positive culture >48 h after admission, and included colonizations and infections (defined by clinical records). Controls had at least two negative perirectal screens and no positive cultures. Risk factors for KPCO acquisition, first infection following acquisition, and 14-day mortality following each episode of infection were identified using multi-variable logistic regression.
resultsIn 303 cases (89 with at least one infection) and 5929 controls, risk factors for KPCO acquisition included: longer inpatient stay, transfusion, complex thoracic pathology, mechanical ventilation, dialysis, and exposure to carbapenems and β-lactam/β-lactamase inhibitors. Exposure to other KPCO-colonized patients was only a risk factor for acquisition in a single unit, suggesting that direct patient-to-patient transmission did not play a major role. There were 15 species of KPCO; 61 (20%) cases were colonized/infected with more than one species. Fourteen-day mortality following non-urinary KPCO infection was 20% (20/97 episodes) and was associated with failure to achieve source control.
conclusionsHealthcare exposures, antimicrobials and invasive procedures increased the risk of KPCO colonization/infection, suggesting potential targets for infection control interventions in multi-species outbreaks. Evidence for patient-to-patient transmission was limited.
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