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00925njm 22002777a 4500 dc Salamanca-Rivera, Elena author Palacios-Baena, Zaira R author Cañada-Garcia, Javier Enrique author Moure García, Zaira author Perez-Vazquez, Maria author Calvo-Montes, Jorge author Martínez-Martínez, Luis author Cantón, Rafael author Ruiz Carrascoso, Guillermo author Pitart, Cristina author Navarro, Ferran author Bou, Germán author Mulet, Xavier author González-López, Juan José author Sivianes, Fran author Delgado-Valverde, Mercedes author Pascual, Álvaro author Oteo-Iglesias, Jesus author Rodríguez-Baño, Jesús author GEMARA/GEIRAS-SEIMC/REIPI CARB-ES-19 Study Group author 2024-12 Background: Community-acquired (CA) and healthcare-associated (HCA) infections caused by carbapenemase-producing Enterobacterales (CPE) are not well characterized. The objective was to provide detailed information about the clinical and molecular epidemiological features of nosocomial, HCA and CA infections caused by carbapenemase-producing Klebsiella pneumoniae (CP-Kp) and Escherichia coli (CP-Ec). Methods: A prospective cohort study was performed in 59 Spanish hospitals from February to March 2019, including the first 10 consecutive patients from whom CP-Kp or CP-Ec were isolated. Patients were stratified according to acquisition type. A multivariate analysis was performed to identify the impact of acquisition type in 30-day mortality. Results: Overall, 386 patients were included (363 [94%] with CP-Kp and 23 [6%] CP-Ec); in 296 patients (76.3%), the CPE was causing an infection. Acquisition was CA in 31 (8.0%) patients, HCA in 183 (47.4%) and nosocomial in 172 (48.3%). Among patients with a HCA acquisition, 100 (54.6%) had been previously admitted to hospital and 71 (38.8%) were nursing home residents. Urinary tract infections accounted for 19/23 (82.6%), 89/130 (68.5%) and 42/143 (29.4%) of CA, HCA and nosocomial infections, respectively. Overall, 68 infections (23%) were bacteremia (8.7%, 17.7% and 30.1% of CA, HCA and nosocomial, respectively). Mortality in infections was 28% (13%, 14.6% and 42.7% of CA, HCA and nosocomial, respectively). Nosocomial bloodstream infections were associated with increased odds for mortality (adjusted OR, 4.00; 95%CI 1.21-13.19). Conclusions: HCA and CA infections caused by CPE are frequent and clinically significant. This information may be useful for a better understanding of the epidemiology of CPE. Salamanca-Rivera E, Palacios-Baena ZR, Cañada JE, Moure Z, Pérez-Vázquez M, Calvo-Montes J, Martínez-Martínez L, Cantón R, Ruiz Carrascoso G, Pitart C, Navarro F, Bou G, Mulet X, González-López JJ, Sivianes F, Delgado-Valverde M, Pascual Á, Oteo-Iglesias J, Rodríguez-Baño J; GEMARA/GEIRAS-SEIMC/REIPI CARB–ES–19 Group. Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain. Infection. 2024 Dec;52(6):2231-2240. 10.1007/s15010-024-02267-0 1439-0973 0300-8126 Infection 38703288 https://hdl.handle.net/20.500.12105/26434 Carbapenem resistant Enterobacterales Clinical features KPC-3 OXA-48 Risk factors Epidemiological and clinical characterization of community, healthcare-associated and nosocomial colonization and infection due to carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in Spain