ArticleBMC infectious diseases2026
Carbapenemase-producing Enterobacterales infections: a real-world cohort study from a secondary hospital in Shanghai, China.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- A review of bloodstream infections-pathogens, pathogenesis, diagnostic strategies, treatment methods-challenges and future aspects.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Review
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Abstract
backgroundCarbapenem-resistant Enterobacterales (CRE) have become a major global public health concern. The production and spread of carbapenemases have rendered carbapenemase-producing Enterobacterales (CPE) a severe clinical threat. Epidemiological data regarding CPE infections remain scarce in secondary hospitals. This study aims to characterize carbapenemase phenotypes and antimicrobial resistance profiles of CRE isolates from a secondary hospital, and explore factors associated with patient clinical outcome.
methodsA cohort study was conducted on clinical CRE isolates collected from January 2023 to September 2024. Carbapenemases were identified by immunochromatography. Univariate and multivariate logistic regression models were conducted to identify factors associated with clinical failure of CPE-infected patients.
resultsOf 131 strains from enrolled CRE infected patients, the detection rate of carbapenemases was 100% via immunochromatography. Phenotypes distribution revealed 98 (74.8%) Klebsiella pneumoniae carbapenemase (KPC), 25 (19.1%) metallo-β-lactamases (MBL) and 8 (6.1%) double carbapenemases-producer (DCP), with distinct antimicrobial resistance features across groups. Elevated aCCI (aOR 1.4, 95% CI 1.1-1.8, p = 0.007), mechanical ventilation (aOR 7.8, 95% CI 2.2-28.1, p = 0.002) and hospital-onset (aOR 6.7, 95% CI 2.0-23.0, p = 0.002) were independent factors associated with clinical failure.
conclusionThe secondary hospitals face intense carbapenemase prevalence pressure and complex resistance profiles, particularly among DCP strains. Patients with more comorbidities and hospital-acquired infection may develop poor clinical outcomes. These findings underscore the urgent need for enzyme-guided precision therapy and tailored infection control strategies in these high-risk, community-linked medical institutions. CLINICAL TRIAL NUMBER: Not applicable.
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