Table 1. Baseline characteristics of the Carbapenemase-producing Enterobacteriacea (CPE) patients according to carbapenemase type among index patients or secondary patients.
| Variable | Index patient | Secondary patient | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Total (N = 211) | KPC (N = 52) | NDM-1 (N = 109) | Othersa (N = 50) | P-valueb | Total (N = 44) | KPC (N = 24) | NDM-1 (N = 16) | Othersa (N = 4) | P-valueb | ||
| Age, median years | 63.0 | 67.0 | 62.0 | 58.0 | 0.02 | 62.0 | 61.5 | 59.0 | 76.0 | 0.69 | |
| Male | 146 (69) | 35 (67) | 73 (67) | 38 (76) | 0.97 | 30 (68) | 15 (63) | 11 (69) | 4 (100) | 0.69 | |
| Source of isolated CPE | |||||||||||
| Blood | 41 (19) | 9 (17) | 26 (24) | 6 (12) | 0.35 | 2 (5) | 2 (8) | 0 | 0 | 0.51 | |
| Sputum | 30 (14) | 14 (27) | 10 (9) | 6 (12) | 0.003 | 4 (9) | 3 (13) | 0 | 1 (25) | 0.26 | |
| Urine | 56 (27) | 11 (21) | 24 (22) | 21 (42) | 0.90 | 2 (5) | 1 (4) | 1 (6) | 0 | >0.99 | |
| Stool | 23 (11) | 5 (10) | 14 (13) | 4 (8) | 0.55 | 34 (77) | 16 (67) | 15 (94) | 3 (75) | 0.06 | |
| Wound | 36 (17) | 7 (14) | 21 (19) | 8 (16) | 0.36 | 0 | 0 | 0 | 0 | - | |
| Bile fluid | 16 (8) | 3 (6) | 10 (9) | 3 (6) | 0.55 | 1 (2) | 1 (4) | 0 | 0 | >0.99 | |
| Ascitic fluid | 8 (4) | 2 (4) | 4 (4) | 2 (4) | >0.99 | 1 (2) | 1 (4) | 0 | 0 | >0.99 | |
| Catheter | 1 (1) | 1 (2) | 0 | 0 | 0.32 | 0 | 0 | 0 | 0 | - | |
| Enterobacteriacea spp. | |||||||||||
| Klebsiella pneumoniae | 106 (50) | 47 (90) | 35 (32) | 24 (48) | <0.001 | 32 (73) | 24 (100) | 6 (38) | 2 (50) | <0.001 | |
| Enterobacter spp. | 43 (20) | 0 | 34 (31) | 9 (18) | <0.001 | 4 (9) | 0 | 4 (25) | 0 | 0.02 | |
| Klebsiella oxytoca | 23 (11) | 1 (2) | 13 (12) | 9 (18) | 0.04 | 4 (9) | 0 | 2 (13) | 2 (50) | 0.15 | |
| Citrobacter freundii | 16 (8) | 1 (2) | 9 (8) | 6 (12) | 0.17 | 4 (9) | 0 | 4 (25) | 0 | 0.02 | |
| Escherichia coli | 16 (8) | 3 (6) | 12 (11) | 1 (2) | 0.39 | 0 | 0 | 0 | 0 | - | |
| Serratia marscescens | 6 (3) | 0 | 5 (5) | 1 (2) | 0.18 | 0 | 0 | 0 | 0 | - | |
| Morganella morganiic | 1 (1) | 0 | 1 (1) | 0 | >0.99 | 0 | 0 | 0 | 0 | - | |
| Underlying disease | |||||||||||
| Diabetes mellitus | 65 (31) | 22 (42) | 27 (25) | 16 (32) | 0.02 | 11 (25) | 6 (25) | 4 (25) | 1 (25) | >0.99 | |
| Liver disease | 44 (21) | 14 (27) | 26 (24) | 4 (8) | 0.67 | 26 (59) | 20 (83) | 6 (38) | 0 | 0.01 | |
| Immunosuppressive state | 50 (24) | 10 (19) | 28 (26) | 12 (24) | 0.37 | 16 (36) | 11 (46) | 5 (31) | 0 | 0.36 | |
| Hematologic malignancy | 16 (8) | 3 (6) | 9 (8) | 4 (8) | 0.75 | 2 (5) | 0 | 1 (6) | 1 (25) | 0.40 | |
| Solid cancer | 74 (35) | 18 (35) | 39 (36) | 17 (34) | 0.89 | 16 (36) | 8 (33) | 6 (38) | 2 (50) | 0.79 | |
| Renal failure | 36 (17) | 13 (25) | 14 (13) | 9 (18) | 0.05 | 6 (14) | 2 (8) | 2 (13) | 2 (50) | >0.99 | |
| COPD | 7 (3) | 2 (4) | 3 (3) | 2 (4) | 0.66 | 1 (2) | 0 | 1 (6) | 0 | 0.40 | |
| Risk factor for CPE infection | |||||||||||
| Previous broad-spectrum antibiotic use | 193 (92) | 48 (92) | 102 (94) | 43 (86) | 0.75 | 43 (98) | 23 (96) | 16 (100) | 4 (100) | >0.99 | |
| Previous carbapenem use | 85 (40) | 21 (40) | 42 (39) | 22 (44) | 0.82 | 19 (43) | 12 (50) | 5 (31) | 2 (50) | 0.24 | |
| Previous ICU admission | 98 (46) | 26 (50) | 47 (43) | 25 (50) | 0.41 | 26 (59) | 16 (67) | 8 (50) | 2 (50) | 0.29 | |
| Previous surgery | 116 (55) | 26 (50) | 57 (52) | 33 (66) | 0.79 | 23 (52) | 14 (58) | 8 (50) | 1 (25) | 0.60 | |
| Indwelling catheter | 196 (93) | 48 (92) | 100 (92) | 48 (96) | >0.99 | 40 (91) | 22 (92) | 14 (88) | 4 (100) | >0.99 | |
| Invasive infection | 120 (57) | 30 (58) | 66 (61) | 24 (48) | 0.73 | 5 (11) | 5 (21) | 0 | 0 | 0.07 | |
| 3-month mortality | 38 (18) | 6 (12) | 21 (19) | 11 (22) | 0.22 | 7 (16) | 4 (17) | 3 (19) | 0 | >0.99 | |
| Days from admission to CPE infection/colonization, median | 20.0 | 13.5 | 22.0 | 23.0 | 0.02 | - | - | - | - | - | |
| Acquisition | |||||||||||
| Hospital-acquired infection | 169 (80) | 33 (64) | 91 (84) | 45 (90) | 0.005 | - | - | - | - | - | |
| Community-acquired infection | 13 (6) | 5 (10) | 5 (5) | 3 (6) | 0.30 | - | - | - | - | - | |
| Healthcare-associated infection | 28 (13) | 13 (25) | 13 (12) | 2 (4) | 0.04 | - | - | - | - | - | |
| Exposure time (days), median | - | - | - | - | - | 5.0 | 5.0 | 5.5 | 7.5 | 0.70 | |
| Type of room exposed | |||||||||||
| Two-bed room | - | - | - | - | - | 1 (2) | 0 | 1 (6) | 0 | 0.40 | |
| Multi-patient room | - | - | - | - | - | 16 (36) | 9 (38) | 6 (38) | 1 (25) | >0.99 | |
| ICU | - | - | - | - | - | 27 (61) | 15 (63) | 1 (25) | 3 (75) | 0.69 | |
Data are presented as number of patients (%), unless otherwise specified.
aOther: VIM (42), OXA (6), non-specified (2).
bP-value obtained by comparing KPC and NDM-1.
cMorganella morganii was defined as carbapenem resistant Enterobacteriaceae as a strain resistant to meropenem.
KPC, Klebsiella pneumoniae carbapenemase; NDM-1, New Delhi metallo-beta-lactamase; COPD, chronic obstructive pulmonary disease; ICU, intensive care unit; VIM, verona integron-encoded metallo-beta-lactamase; OXA, oxacillin carbapenemases.