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Background Carbapenem-resistant Enterobacteriaceae (CRE) infections are spreading worldwide and have become a global menace. Different types of carbapenemases contribute to carbapenem resistance. The outcome of patients with IMP-type carbapenemase-producing CRE (IMP-CRE) is not well known. Methods A matched case–control study from January 2012 to December 2016 was conducted at NCGM. All unique patients with IMP-CRE isolation were included and matched with carbapenem-sensitive Enterobacteriaceae (CSE) patients. Meropenem non-susceptible and/or ceftazidime-resistant Enterobacteriaceae, per CLSI criteria, were tested for metallo-β-lactamase production with further confirmation of blaIMP by PCR. Multivariate analyses were conducted for outcomes, adjusting for a propensity score predicting the likelihood of isolation of CRE vs. CSE. The balance of each group was determined by standardized biases Results In total, 192 patients (96 CRE, 96 CSE) were included (132 Enterobacter sp., 60 Klebsiella pneumoniae). Isolations sites were sputum (n = 76 [39.6%]), urine (n = 62 [32.3%]), blood (n = 22 [11.3%]), and wound (n = 14 [7.2%]). The median age of the patients was 75 years [IQR: 66–84], and 109 (56.8%) were male. Thirty-one (32.3%) patients with CRE and 55 (57.3%) patients with CSE developed infections. The others were considered as colonization. qSOFA was positive (≥2) in seven patients with CRE infection and nine with CSE infection. In bivariate analysis, mortality and length of hospital stay (LOS) after CRE/CSE isolation were similar between the two groups, even after stratification by bacterial species and infection/colonization. After controlling for the propensity score (table), mortality and LOS remained similar between the two groups. Conclusion IMP-CRE might not contribute to the worsened clinical outcomes when compared with CSE. Further evaluations are needed for additional outcome parameters. Disclosures All authors: No reported disclosures. |
