Ahead of Print -Deaths Attributable to Carbapenem-Resistant Enterobacteriaceae Infections - Volume 20, Number 7—July 2014 - Emerging Infectious Disease journal - CDC
Volume 20, Number 7—July 2014
Deaths Attributable to Carbapenem-ResistantEnterobacteriaceae Infections
Deaths Attributable to Carbapenem-Resistant EnterobacteriaceaeInfections
Matthew E. Falagas1 , Giannoula S. Tansarli1, Drosos E. Karageorgopoulos1, and Konstantinos Z. Vardakas1
Author affiliations: Alfa Institute of Biomedical Sciences, Athens, Greece (M.E. Falagas, G.S. Tansarli, D.E. Karageorgopoulos, K.Z. Vardakas); Hellenic Center for Disease Control and Prevention, Athens (D.E. Karageorgopoulos); IASO Group, Athens (M.E. Falagas, K.Z. Vardakas); Tufts University School of Medicine, Boston, Massachusetts, USA (M.E. Falagas)
Carbapenem-resistant strains have emerged among species belonging to the Enterobacteriaceaefamily (1,2). Carbapenemases are a class of enzymes that can confer resistance to carbapenems and other β-lactam antibiotic drugs, but not all carbapenemase-producing isolates are carbapenem-resistant (3,4). Among the known carbapenemases are Klebsiella pneumoniaecarbapenemase (KPC) and Verona integrin–encoded metallo-β-lactamase (VIM) (5). Several outbreaks caused by carbapenem-resistant Enterobacteriaceae (CRE) have been recorded in health care facilities around the world (6–13), and in some places, CRE have become endemic (14–18). Serious concurrent conditions (3,4,19–22) and prior use of fluoroquinolones (20,23,24), carbapenems (22,25), or broad-spectrum cephalosporins (20,22) have been independently associated with acquisition of infections caused by CRE.
Several studies have provided data regarding clinical outcomes for CRE infections. However, controversy remains concerning the number of deaths among persons infected with CRE compared with the number among persons infected with carbapenem-susceptibleEnterobacteriaceae (CSE) (23,26). In this context, the goal of our study was to evaluate the number of deaths attributable to CRE infections by conducting a systematic review and metaanalysis of the available data.
Prof. Falagas, MD, MSc, DSc, is founder and director of the Alfa Institute of Biomedical Sciences, Athens, Greece; adjunct associate professor of Medicine at Tufts University School of Medicine, Boston, Massachusetts, USA; and director of the Department of Internal Medicine–Infectious Diseases, Iaso General Hospital, Iaso Group, Athens, Greece. His research interests include antimicrobial drug resistance and nosocomial infections.
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- Figure. Selection process for studies included in a systematic review and metaanalysis of deaths attributable to carbapenem-resistant Enterobacteriaceae infectionsCRE, carbapenem-resistant Enterobacteriaceae; CSE, carbapenem-susceptible Enterobacteriaceae; KPC, Klebsiella pneumoniae carbapenemase; ESBL, extended-spectrum β-lactamase....
- Technical Appendix. Characteristics and outcomes of studies included in a systematic review and metaanalysis of deaths attributable to carbapenem-resistant Enterobacteriaceae infections and death risk ratios for patients infected with carbapenem-resistant Enterobacteriaceae... 249 KB
Suggested citation for this article: Falagas ME, Tansarli GS, Karageorgopoulos DE, Vardakas KZ. Deaths attributable to carbapenem-resistant Enterobacteriaceae infections. Emerg Infect Dis. 2014 Jul [date cited]. http://dx.doi.org/10.3201/eid2007. 121004
1All authors contributed equally to this article.