title: Infections caused by carbapenemase-producing Enterobacteriaceae: risk factors, clinical features and prognosis.
abstract: Infections caused by carbapenem-producing Enterobacteriaceae (CPE) can present as several infectious syndromes, but they primarily present as respiratory, urinary and blood stream infections (primary or catheter-related) that are usually found as nosocomial or healthcare-associated infections. The risk of CPE infection is influenced by individual factors, such as the length of the hospital stay and their exposure to invasive procedures and/or to antimicrobials. Of note, exposure to several antimicrobials, not only carbapenems, has been linked to CPE colonization; the duration of antibiotic exposure is one of the primary drivers of CPE acquisition. Individual risk factors must be considered jointly with the local epidemiology of these microorganisms in healthcare institutions. Overall, these infections have a high associated mortality. Mortality is influenced by host factors (e.g., age, comorbidity and immune deficiency), infection-related variables (e.g., type and severity of the infection) and treatment-related factors such as the delay in the initiation of appropriate antimicrobial therapy and the use or monotherapy or combined antimicrobial therapy. Gaining knowledge concerning the epidemiology, clinical features and prognostic features of CPE infection could be useful for improving infection prevention and for the management of patients with infections caused by these microorganisms.
authors.affiliation: Unidad de Enfermedades Infecciosas y Microbiología Clínica, Departamento de Medicina Interna, Hospital Universitario La Paz, IDIPAZ, Madrid, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Paño Pardo
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Serrano Villar
authors.affiliation: Unidad de Enfermedades Infecciosas y Microbiología Clínica, Departamento de Medicina Interna, Hospital Universitario La Paz, IDIPAZ, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Ramos Ramos
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Pintado
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism* / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D015780:Carbapenems / Q000378:metabolism* / Q000627:therapeutic use; D002353:Carrier State / Q000453:epidemiology; D015897:Comorbidity; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004198:Disease Susceptibility; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D019353:Endemic Diseases; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D006801:Humans; D011183:Postoperative Complications / Q000382:microbiology; D011379:Prognosis; D012307:Risk Factors; D015163:Superinfection; D014195:Travel; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Bacteriemia; Bloodstream infections; Características clínicas; Carbapenemase-producing; Clinical features; Enterobacteriaceae; Enterobacterias productoras de carbapenemasas; Factores de riesgo; Factores pronósticos; Prognostic factors; Risk factors