title: KPC-producing Enterobacter aerogenes infection.
abstract: BACKGROUND
  Enterobacter is a common nosocomial microorganism and its carbapenem's resistance has increased. The management of these cases is unclear.
  
  
  OBJECTIVE
  We evaluated 16 patients with KPC-producing Enterobacter aerogenes infections, detailing the site of infection, therapy, clinical and epidemiological data.
  
  
  METHODS
  A retrospective and descriptive study. Clinical data were revised and KPC-2 detection was by molecular methods. Risk factors associated with mortality were compared using appropriate tests according to variable type with a significance level of 0.05.
  
  
  RESULTS
  The 30-day mortality rate was 37.5% with no association with inadequate treatment. Age (p=0.004) and Charlson score of comorbidities (p=0.048) were independent risk factors associated with death in the multivariate analysis. The odds ratio for age >43 years was 3.00 (95% CI: 1.02-9.32) and for Charlson score >3 was 2.00 (95% CI: 1.08-3.71). Five strains were pan-resistant based on automated susceptibility tests. All patients were treated with monotherapy.
  
  
  CONCLUSIONS
  The clinician should be alert to carbapenem-resistant Enterobacteriaceae infection in older patients with comorbidities. The mortality is high and we believe that prompt and adequate therapy must be employed.
authors.affiliation: Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brazil. Electronic address: flptuon@gmail.com.
authors.forename: Felipe F
authors.initials: FF
authors.lastname: Tuon
authors.affiliation: Division of Infectious and Parasitic Diseases, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Scharf
authors.affiliation: Division of Microbiology, Frischmann Aisengart/DASA Medicina Diagnóstica, Curitiba, PR, Brazil.
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Rocha
authors.affiliation: Laboratory of Microbiology, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brazil.
authors.forename: Juliette
authors.initials: J
authors.lastname: Cieslinsk
authors.affiliation: Laboratory of Microbiology, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brazil.
authors.forename: Guilherme Nardi
authors.initials: GN
authors.lastname: Becker
authors.affiliation: Laboratório Central do Estado LACEN-PR, Curitiba, PR, Brazil.
authors.forename: Lavinia N
authors.initials: LN
authors.lastname: Arend
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D021902:Enterobacter aerogenes / Q000187:drug effects* / Q000201:enzymology*; D004756:Enterobacteriaceae Infections / Q000382:microbiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000187:drug effects / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; C491478:beta-lactamase KPC-2; D001618:beta-Lactamases
keywords: Carbapenemase; Enterobacter; Infection control; KPC