ArticleThe Journal of antimicrobial chemotherapy2024
Risk factors for bloodstream infections due to carbapenem-resistant Enterobacterales: a nested case-control-control study.
Article in The Journal of antimicrobial chemotherapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- When might we consider using the newer β-lactam agents as empirical therapy against presumed carbapenem-resistant gram-negative infections?JAC-antimicrobial resistance · 2026Review
- ICU Admission Screening for Multidrug-Resistant Organism Colonization and Subsequent Infection Risk: A Pilot Study.Diagnostics (Basel, Switzerland) · 2026Article
- Incidence and factors associated with carbapenem-resistant Enterobacterales infection among hospitalized internal medicine patients in Korea: a retrospective observational study.Journal of Korean biological nursing science · 2026Article
- Article
- Predictors of resistance and mortality inFrontiers in medicine · 2026Article
- The gut reservoir of carbapenem-resistant Enterobacterales: from dysbiosis and colonization to infection and decolonization, with a focus on patients with hematologic malignancies - a narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Risk Factors and Medical Burden of Multidrug-Resistant Organism Infection in Hospitalized Patients with Pneumonia.Infection and drug resistance · 2026Article
- Prevalence and Types of Inappropriate Antibiotics Prescribing Among Dialysis Patients: A Systematic Review.Antibiotics (Basel, Switzerland) · 2025Review
- Antibiotic therapy for severe bacterial infections.Intensive care medicine · 2025Review
- Risk Factor Analysis of CRE Infections at Different Anatomical Sites in ICU Patients.Antibiotics (Basel, Switzerland) · 2025Article
- Breaking Through Resistance: A Comparative Review of New Beta-Lactamase Inhibitors (Avibactam, Vaborbactam, Relebactam) Against Multidrug-Resistant Superbugs.Antibiotics (Basel, Switzerland) · 2025Review
- Risk Factors and Molecular Epidemiology of Infections Among Patients with Intestinal Colonization by Carbapenem-ResistantInfection and drug resistance · 2025Article
- Risk factors, and outcomes of patients with carbapenem-resistantFrontiers in cellular and infection microbiology · 2025Article
- Bloodstream infection with NDM-1/5Frontiers in cellular and infection microbiology · 2025Article
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24 authors.
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Abstract
backgroundCarbapenem-resistant Enterobacterales (CRE) bloodstream infections (BSIs) are a major threat to patients. To date, data on risk factors have been limited, with low internal and external validity. In this multicentre study, risk factors for CRE BSI were determined by comparison with two control groups: patients with carbapenem-susceptible Enterobacterales (CSE) BSI, and patients without Enterobacterales infection (uninfected patients).
methodsA multicentre, case-control-control study was nested in a European prospective cohort study on CRE (EURECA). CRE BSI:CSE BSI matching was 1:1, CRE BSI:Uninfected patients matching was 1:3, based on hospital, ward and length of stay. Conditional logistic regression was applied.
resultsFrom March 2016 to November 2018, 73 CRE BSIs, 73 CSE BSIs and 219 uninfected patients were included from 18 European hospitals. For CRE versus CSE BSI, previous CRE colonization/infection [incidence rate ratio (IRR) 7.32; 95% CI 1.65-32.38) increased the risk. For CRE versus uninfected controls, independent risk factors included: older age (IRR 1.03; 95% CI 1.01-1.06), patient referral (long-term care facility: IRR 7.19; 95% CI 1.51-34.24; acute care hospital: IRR 5.26; 95% CI 1.61-17.11), previous colonization/infection with other MDR organisms (MDROs) (IRR 9.71; 95% CI 2.33-40.56), haemodialysis (IRR 8.59; 95% CI 1.82-40.53), invasive procedures (IRR 5.66; 95% CI 2.11-15.16), and β-lactam/β-lactamase inhibitor combinations (IRR 3.92; 95% CI 1.68-9.13) or third/fourth generation cephalosporin (IRR 2.75; 95% CI 1.06-7.11) exposure within 3 months before enrolment.
conclusionsEvidence of previous CRE colonization/infection was a major risk factor for carbapenem resistance among Enterobacterales BSI. Compared with uninfected patients, evidence of previous MDRO colonization/infection and healthcare exposure were important risk factors for CRE BSI. Targeted screening, infection prevention and antimicrobial stewardship should focus on these high-risk patients.
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