title: Deaths attributable to carbapenem-resistant Enterobacteriaceae infections.
abstract: We evaluated the number of deaths attributable to carbapenem-resistant Enterobacteriaceae by using studies from around the world published before April 9, 2012. Attributable death was defined as the difference in all-cause deaths between patients with carbapenem-resistant infections and those with carbapenem-susceptible infections. Online databases were searched, and data were qualitatively synthesized and pooled in a metaanalysis. Nine studies met inclusion criteria: 6 retrospective case-control studies, 2 retrospective cohort studies, and 1 prospective cohort study. Klebsiella pneumoniae was the causative pathogen in 8 studies; bacteremia was the only infection in 5 studies. We calculated that 26%-44% of deaths in 7 studies were attributable to carbapenem resistance, and in 2 studies, which included bacteremia and other infections, -3% and -4% of deaths were attributable to carbapenem resistance. Pooled outcomes showed that the number of deaths was significantly higher in patients with carbapenem-resistant infections and that the number of deaths attributable to carbapenem resistance is considerable.
authors: Matthew E
authors: ME
authors: Falagas
authors: Giannoula S
authors: GS
authors: Tansarli
authors: Drosos E
authors: DE
authors: Karageorgopoulos
authors: Konstantinos Z
authors: KZ
authors: Vardakas
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000401:mortality; D015780:Carbapenems / Q000627:therapeutic use*; D016022:Case-Control Studies; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D004755:Enterobacteriaceae / Q000187:drug effects / Q000472:pathogenicity*; D004756:Enterobacteriaceae Infections / Q000401:mortality*; D006801:Humans; D007710:Klebsiella Infections / Q000401:mortality; D007711:Klebsiella pneumoniae / Q000472:pathogenicity; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems
keywords: Enterobacteriaceae; KPC; Klebsiella pneumoniae; Klebsiella pneumoniae carbapenemase; attributable deaths; attributable mortality; bacteremia; bacteria; bloodstream infection; carbapenem resistance; carbapenem-resistant Enterobacteriaceae; carbapenemase-producing; carbapenemases; deaths; infections; meta-analysis; metaanalysis; mortality; outcome; systematic review