July 16, 2014
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Carbapenem resistance responsible for many Enterobacteriaceae deaths

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Among patients with Enterobacteriaceae infections, a high number of deaths appear to be related to carbapenem resistance, according to recent findings.

In a systematic literature review, researchers searched the PubMed and Scopus databases for any article published before April 9, 2012, to evaluate the number deaths attributable to carbapenem-resistant Enterobacteriaceae (CRE) infections. After retrieving 364 articles from the database search, nine met the eligibility requirements for inclusion. The researchers compared the all-cause mortality between patients with CRE and carbapenem-susceptible Enterobacteriaceae (CSE) infections.

The researchers found that in eight of the nine studies, Klebsiella pneumoniae was the causative pathogen of infections; in five studies, bacteremia was the only infection chronicled. Between 26% and 44% of deaths in seven studies were attributable to carbapenem resistance, whereas in two studies, which reported bacteremia and other infections, –3% and –4% of deaths were associated with carbapenem resistance. Based on the pooled outcomes, carbapenem-resistant infections resulted in a significantly higher mortality rate, and a number of these deaths were found to be attributable to carbapenem resistance.

“Further original studies are needed to determine the reason(s) for the increased risk for death from carbapenem-resistant isolates versus carbapenem-susceptible isolates,” the researchers wrote. “Our findings imply a need for strict infection control measures and a need for new antibiotics to protect against CRE infections.”

Disclosure: The researchers report no relevant financial disclosures.