Citations 1
International Epidemiology of Carbapenemase-Producing Escherichia coli
Boutzoukas, Angelique E , Komarow, Lauren , Chen, Liang , Hanson, Blake , Liu, Zhengyin , Mendoza, Soraya Salcedo, Ordóñez, Karen , Wang, Minggui , Ge, Lizhao , Giri, Abhigya, Hill, Carol , Baum, Keri, Kreiswirth, Barry N. , Patel, Robin , Arias, César A. , Chambers, Henry F. , Fowler, Vance G. , Investigators, Multi-Drug Resistant Organism Network, Souha, S Kanj, Jean, Francois Jabbour, Fujie, Zhang, Judith, J Lok, Robert, A Salata, Martin, Stryjewski, Valentina, Di Castelnuovo, Jose, Millan Oñate Gutierrez, Eric, Cober, Susan, Richter, Deverick, J Anderson, Beth, Evans, Carol, Hill, Heather, Reich, Keri, Baum, Rebekka, Arias, Vance, G Fowler, Karen, Ordoñez, Jesse, T Jacob, Li, Linghua , Barry, Neil, Samit, Desai, Erica, Herc, Ezequiel, Cordova, Maria, R Ponisio, Samuel, Vichez, Marisa, Laëtitia , Sandra, Valderrama, Jairo, Figueroa, Cesar, A Arias, An, Qiang , Diane, Panesso, Kirsten, R., Truc, Thanh, Jiachun, Su, Jiang, Jianping , Ming-gui, Wang, Xu, Xiaogang , Yang, Yang , Jose, M Munita, Maria, Spencer, Thamer, Alenazi, Robert, Alain, Steven, Hersch, Susan, Davies, Charles, Huskins, Kerry, G, Robin, Patel, Suzannah, Schmidt-Malan, Sara, Revolinski, Glenn, Wortmann, Robert, C Kalayjian, Greg, Weston, Belinda, Ostrowsky, Gopi, Patel, Daniel, E Furst, Angela, Kim, Julia, Garcia-Diaz, Soraya, Salcedo, John, Jeffy, Zhengyin, Liu, Andrew, Henderson, David, Louis, Qing, Xie, Keith, S Kaye, Gao, Hainv , Yu, Yunsong , Mary, Waters, Bettina, C Fries, Brandon, Eilertson, Kean, Lee Chew, Nares, Smitasin, Paul, Ananth Tambyah, Jason, Christopher, Anton, Peleg, Marcel, L. Saint, Lan-juan, LI , Lauren, Komarow, Lizhao, Ge, Scott, Evans, Todd, McCarty, Henry, Fitjerald , Omai, B Garner, Lilian, M Abbo, David, van Duin, Ebbing, Lautenbach, Jennifer, Harrington, Yohei, Doi, Darren, W Logan, Blake, Hanson, Jinnethe, Reyes, Maria, Virginia Villegas Botero, Lorena, Diaz, Federico, P., Ritu, Banerjee, Sorabh, Dhar, Michael, Joy S, Zhiyong, Zong, Stryjewski, Martín E. , Villegas, María Virginia , Wang, Minggui , Evans, Scott R , Patel, Robin , van Duin, David , Pérez, Federico , Jiang, Jianping , Boutzoukas, Angelique , Chen, Liang , Villegas, Maria Virginia , Kanj, Souha S. , Paterson, David L. , Evans, Scott , Bonomo, Robert A. , Kreiswirth, Barry N , Arias, César A. , Fowler, Vance G. , Investigators, Multi-Drug Resistant Organism Network, Souha, S Kanj, Fujie, Zhang, Jose, Millan-Onate, Eric, Cober, Barry, N Kreiswirth, Claudia, Manca, Marisa, L Sanchez, An, Q Dinh, Kirsten, Rydell, Hu, Fupin , Maria, Spencer-Sandino, Robert, A Bonomo, Steven, H Marshall, Susan, D Rudin, Glenn, Wortmann, Gopi, Patel, Zhengyin, Liu, David, L Paterson, Qing, Xie, Marimuthu, Kalisvar , Anton, Peleg, Henry, F Chambers, Ebbing, Lautenbach, Jennifer, H Han, Lorena, Diaz, Federico, Perez, Ritu, Banerjee, Zhiyong, Zong
Clinical Infectious Diseases | May 8, 2023 | Volume: 77 | Issue: 4 | Pages: 499-509
Abstract Background Carbapenemase-producing (CP) Escherichia coli (CP-Ec) are a global public health threat. We aimed to describe the clinical and molecular epidemiology and outcomes of patients from several countries with CP-Ec isolates obtained from a prospective cohort. Methods Patients with CP-Ec were enrolled from 26 hospitals in 6 countries. Clinical data were collected, and isolates underwent whole-genome sequencing. Clinical and molecular features and outcomes associated with isolates with or without metallo-β-lactamases (MBLs) were compared. The primary outcome was desirability of outcome ranking (DOOR) at 30 days after the index culture. Results Of the 114 CP-Ec isolates in Consortium on resistance against carbapenems in Klebsiella and other Enterobacterales-2 (CRACKLE-2), 49 harbored an MBL, most commonly blaNDM-5 (38/49, 78%). Strong regional variations were noted with MBL-Ec predominantly found among patients in China (23/49). Clinically, MBL-Ec were more often from urine sources (49% vs 29%), less often met criteria for infection (39% vs 58%, P = .04), and had lower acuity of illness when compared with non–MBL-Ec. Among patients with infection, the probability of a better DOOR outcome for a randomly selected patient with MBL-Ec as compared with non–MBL-Ec was 62% (95% CI: 48.2–74.3%). Among infected patients, non–MBL-Ec had increased 30-day (26% vs 0%; P = .02) and 90-day (39% vs 0%; P = .001) mortality compared with MBL-Ec. Conclusions Emergence of CP-Ec was observed with important geographic variations. Bacterial characteristics, clinical presentations, and outcomes differed between MBL-Ec and non–MBL-Ec. Mortality was higher among non-MBL isolates, which were more frequently isolated from blood, but these findings may be confounded by regional variations.