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A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States
Journal article   Open access   Peer reviewed

A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States

Daniel J Livorsi, Margaret L Chorazy, Marin L Schweizer, Erin C Balkenende, Amy E Blevins, Rajeshwari Nair, Matthew H Samore, Richard E Nelson, Karim Khader and Eli N Perencevich
Antimicrobial resistance and infection control, Vol.7(1), pp.55-55
2018
DOI: 10.1186/s13756-018-0346-9
PMCID: PMC5926528
PMID: 29719718
url
https://doi.org/10.1186/s13756-018-0346-9View
Published (Version of record) Open Access

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) pose an urgent public health threat in the United States. An important step in planning and monitoring a national response to CRE is understanding its epidemiology and associated outcomes. We conducted a systematic literature review of studies that investigated incidence and outcomes of CRE infection in the US. We performed searches in MEDLINE via Ovid, CDSR, DARE, CENTRAL, NHS EED, Scopus, and Web of Science for articles published from 1/1/2000 to 2/1/2016 about the incidence and outcomes of CRE at US sites. Five studies evaluated incidence, but many used differing definitions for cases. Across the entire US population, the reported incidence of CRE was 0.3-2.93 infections per 100,000 person-years. Infection rates were highest in long-term acute-care (LTAC) hospitals. There was insufficient data to assess trends in infection rates over time. Four studies evaluated outcomes. Mortality was higher in CRE patients in some but not all studies. While the incidence of CRE infections in the United States remains low on a national level, the incidence is highest in LTACs. Studies assessing outcomes in CRE-infected patients are limited in number, small in size, and have reached conflicting results. Future research should measure a variety of clinical outcomes and adequately adjust for confounders to better assess the full burden of CRE.
Anti-Bacterial Agents - therapeutic use Enterobacteriaceae Infections - epidemiology United States - epidemiology Carbapenem-Resistant Enterobacteriaceae - isolation & purification Long-Term Care - statistics & numerical data Carbapenems - therapeutic use Hospitals - statistics & numerical data Cross Infection - microbiology Enterobacteriaceae Infections - microbiology Humans Cross Infection - epidemiology Incidence

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