ArticleAnnals of clinical microbiology and antimicrobials2023
Risk factors and molecular epidemiology of fecal carriage of carbapenem resistant Enterobacteriaceae in patients with liver disease.
Article in Annals of clinical microbiology and antimicrobials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 13 citations in OpenAlex.
- Determinants of Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Risk factors associated with rectal carriage of carbapenem resistant Enterobacterales in northern Nigeria: a hospital surveillance.BMC infectious diseases · 2025Article
- Clonal dissemination of carbapenem-resistant Klebsiella pneumoniae in outpatients as fecal-carriages: predominance of the high-risk clone ST231.BMC infectious diseases · 2025Article
- Epidemiology and resistance mechanisms of tigecycline- and carbapenem-resistantFrontiers in microbiology · 2025Article
- Burden and Management of Multi-Drug Resistant Organism Infections in Solid Organ Transplant Recipients Across the World: A Narrative Review.Transplant international : official journal of the European Society for Organ Transplantation · 2024Review
- Asymptomatic gastrointestinal carriage of multidrug-resistant carbapenemase-producing Enterobacteriaceae among children under five years in a Kenyan hospital.IJID regions · 2023Article
- Virulence analysis and antibiotic resistance of Klebsiella pneumoniae isolates from hospitalised patients in Poland.Scientific reports · 2023Article
- Fecal carriage and genetic characteristics of carbapenem-resistant enterobacterales among adults from four provinces of China.Frontiers in epidemiology · 2023Article
- Outcomes of Living Donor Liver Transplantation in Recipients Colonized With Carbapenem-Resistant Enterobacterales.Journal of clinical and experimental hepatologyArticle
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8 authors at 2 institutions in 1 country.
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Abstract
backgroundCarbapenem resistant Enterobacteriaceae (CRE) colonization is a risk factor for CRE infection. CRE infection results in an increase in mortality in patients with cirrhosis. However, minimal data regarding the prevalence and the risk factors of CRE colonization in patients with liver disease yet without liver transplantation are available. The present study aimed to investigate the prevalence, risk factors and molecular epidemiology characteristics of CRE fecal carriage among patients with liver disease.
methodsStool specimens from 574 adult inpatients with liver disease were collected from December 2020 to April 2021. CRE were screened using selective chromogenic agar medium and identified by the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Antimicrobial susceptibility was determined using the broth microdilution method. Carbapenemase genes were characterized by polymerase chain reaction (PCR) and DNA sequencing. Multilocus sequence typing (MLST) was performed for Carbapenem Resistant Klebsiella pneumoniae (CR-KPN) isolates and Carbapenem Resistant Escherichia Coli (CR-ECO) isolates.
resultsThe total number of stool specimens (732) were collected from 574 patients with liver disease. 43 non-duplicated CRE strains were isolated from 39 patients with a carriage rate of 6.79% (39/574). The carriage rate was 15.60% (17/109) in patients with acute-on-chronic liver failure (ACLF). Multivariate analysis indicated that ACLF (P = 0.018), the history of pulmonary infection within past 3 months (P = 0.001) and the use of third generation cephalosporin/β-lactamases inhibitor within past 3 months (P = 0.000) were independent risk factors of CRE colonization in patients with liver disease. Klebsiella Pnuemoniae (KPN) (51.28%) and Escherichia coli (ECO) (30.77%) were main strains in these patients. All CRE strains showed high resistance to most antimicrobials except for polymyxin B and tigecycline. Most (83.72%, 36/43) of the CRE carried carbapenemase genes. bla
conclusionsThe present study revealed that CRE fecal carriage rates were higher in patients with ACLF than in patients without liver failure. ACLF, the history of pulmonary infection within past 3 months and the use of third generation cephalosporin/β-lactamases inhibitor within past 3 months were independent risk factors of CRE colonization in patients with liver disease. Regular CRE screening for hospitalized patients with liver disease should be conducted to limit the spread of CRE strain.
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