ArticleBMC infectious diseases2025
Carbapenem-resistant Enterobacterales bloodstream infections related to death in two Brazilian tertiary hospitals.
Article in BMC infectious diseases, 2025. 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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Who cites it
9 citing papers in PubMed.
- Klebsiella pneumoniae from community-acquired infections and an urban river share antimicrobial resistance profiles and high-risk lineages but differ in virulence.Archives of microbiology · 2026Article
- Article
- Epidemiology and clinical outcomes of carbapenamase-producing organism (CPO) colonization: a tertiary care center experience in Saudi Arabia.BMC infectious diseases · 2026Article
- Article
- Clinical Outcomes of Bloodstream Infections in Liver Transplant Recipients: A Ten-Year Single-Center Retrospective Analysis, from Türkiye.Antibiotics (Basel, Switzerland) · 2026Article
- The Caribbean under the radar? A scoping review of carbapenemase-producing Enterobacterales across the region.PLOS global public health · 2026Article
- Empiric Imipenem/Cilastatin/Relebactam for Febrile Neutropenia After Allogeneic Hematopoietic Stem Cell Transplantation: Two Case Reports.Journal of blood medicine · 2026Article
- Resistance Landscape and Clonal Dynamics of ESKAPE Pathogens in Bloodstream Infections: A Multicenter Study from Mexico.Pathogens (Basel, Switzerland) · 2025Article
- Risk factors, and outcomes of patients with carbapenem-resistantFrontiers in cellular and infection microbiology · 2025Article
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10 authors.
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Abstract
backgroundBloodstream infection (BSI) caused by carbapenem-resistant Enterobacterales (CRE) is a major global public health concern due to its high lethality and limited treatment options. In Brazil, CRE was first reported in 2005, with Klebsiella pneumoniae carbapenemase (KPC) documented in 2009. Despite ongoing reports, data remain limited in several regions.
objectiveTo describe the lethality rate and epidemiological and clinical characteristics of BSI patients with Enterobacterales BSI and assess carbapenem resistance to identify major risk factors for CRE infection and lethality.
methodsThis prospective laboratory-based surveillance study, which was conducted in two tertiary hospitals (April 2016-December 2018), analyzed BSI cases caused by Enterobacterales. Clinical and demographic data were obtained from medical records. The bacterial isolates were identified by mass spectrometry and by VITEK-2
resultsAmong 252 patients with enterobacterial BSIs were identified, of which 14.3% had CRE. The overall lethality rate was 37.7%. Compared with carbapenem-susceptible Enterobacterales, CRE-associated BSIs were associated with significantly greater lethality (71.6% vs. 28.4%; p < 0.001; OR = 6.53, 95% CI [3.01-15.41]). The association remained significant after adjusting for age, comorbidities, Pitt bacteremia score, Enterobacterales species, BSI type, and sepsis. All CRE BSI cases were hospital-acquired.
conclusionsCRE accounts for 14.3% of BSIs and is strongly associated with increased lethality. Given the limited epidemiological data in Brazil, this study provides valuable epidemiological insights that may inform local treatment protocols for Enterobacterales infections.
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