Bloodstream infections (BSIs) triggered by carbapenem-resistant Enterobacterales (CRE) have turned into a worldwide health challenge due primarily to their elevated mortality rate and restricted treatment alternatives. Brazil reported the first case of CRE infection in 2005 and the presence of Klebsiella pneumoniae carbapenemase (KPC) identified in 2009. However, comprehensive data on the extent of the issue across many parts of the country is insufficient.
A prospectively conducted study, extending from April 2016 to December 2018, scrutinized BSIs instigated by Enterobacterales within two tertiary hospitals. The researchers concentrated their efforts on describing the mortality rate and identifying the clinical and epidemiological characteristics of BSI patients suffering from Enterobacterales. They evaluated carbapenem resistance to recognize the principal risk factors leading to CRE infection and accompanying mortality.
A total of 252 patients, out of which 14.3% were CRE-afflicted, and the overall lethality rate was discovered to be at 37.7%. When compared with carbapenem-susceptible Enterobacterales, BSIs associated with CRE were connected with significantly higher lethality. Containing the present epidemiological deficit in Brazil, this study provides vital insights that could play a crucial role in molding local treatment protocols for combating Enterobacterales infections.
State-of-the-art antibiotic options existing today to treat CRE-induced infections are scarce and demand reliable and effective therapeutic solutions. Several factors like Charlson comorbidity index (CCI), the severity of BSI, contribution of sepsis or septic shock, and others have been associated with a higher mortality rate in the patient population suffering from multi-drug resistant (MDR) gram-negative bacterial infections. It is essential to obtain epidemiological data to formulate effective antimicrobial stewardship strategies and detect patients at an elevated risk of poor health outcomes.
The primary objective of this study was to report mortality rates, decipher the carbapenem resistance among enterobacterial isolates, recognize the lethal risk factors in CRE BSI patients and to discuss the sociodemographic and clinical characteristics of these patients. The secondary objective was to investigate the antimicrobial susceptibility profile of Enterobacterales isolates and to include resistance to polymyxins and other first-line antibiotics employed in the treatment of CRE infections in Brazil.
Source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11115-x