ArticleAnnals of clinical microbiology and antimicrobials2023
Risk factors associated with colistin resistance in carbapenemase-producing Enterobacterales: a multicenter study from a low-income country.
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 4 papers.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Genomic Characterization of Carbapenem-ResistantMicroorganisms · 2025Article
- Understanding Recent Developments in Colistin Resistance: Mechanisms, Clinical Implications, and Future Perspectives.Antibiotics (Basel, Switzerland) · 2025Review
- Bacteriophage-derived depolymerase: a review on prospective antibacterial agents to combat Klebsiella pneumoniae.Archives of virology · 2025Review
- Clinical pharmacists' involvement in carbapenem antibiotics management at Wenzhou Integrated Hospital.World journal of clinical cases · 2023Article
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
Abstract
purposeThe aim of this study was to assess the risk factors for colistin-resistant carbapenemase-producing Enterobacterales (CR-CPE), and describe the mortality associated with this organism, in a low-income country.
methodsA descriptive, observational, and prospective multicenter study was carried out in Guayaquil, Ecuador. All patients with carbapenem-resistant Enterobacterales admitted between December 2021 and May 2022 were enrolled. Infection definitions were established according to the Centers for Disease Control and Prevention (CDC) protocols. The presence of carbapenemase-producing Enterobacterales was confirmed with a multiplex PCR for bla
resultsOut of 114 patients enrolled in the study, 32 (28.07%) had at least one positive sample for CR-CPE. Klebsiella pneumoniae ST512-KPC-3 was the most frequent microorganism isolated. Parenteral feeding, β-lactamase inhibitor use, recent hemodialysis, and renal failure were all considered independent risk factors for carrying CR-CPE. A mortality of 41.22% was detected, but we could not find any difference between colistin-resistant and colistin-susceptible CPE. MCR-1 production was not detected in any of the isolates studied.
conclusionA significant burden for CR-CPE was found in a South American country that was mainly caused by the high-risk clone K. pneumoniae ST512-KPC-3 and not mediated by mcr-1 production. Its acquisition involved parenteral feeding, β-lactamase inhibitor use, recent hemodialysis, and renal failure as independent risk factors, demonstrating the critical need for infection prevention and stewardship programs to avoid dissemination to other countries in the region.
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Registered trials
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