KPC-producing Enterobacter aerogenes infection

Braz J Infect Dis. 2015 May-Jun;19(3):324-7. doi: 10.1016/j.bjid.2015.01.003. Epub 2015 Feb 23.

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.

Conclusion: 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.

Keywords: Carbapenemase; Enterobacter; Infection control; KPC.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology*
  • Enterobacter aerogenes / drug effects*
  • Enterobacter aerogenes / enzymology*
  • Enterobacteriaceae Infections / microbiology*
  • Enterobacteriaceae Infections / mortality
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Pregnancy
  • Retrospective Studies
  • Risk Factors
  • Young Adult
  • beta-Lactamases / drug effects
  • beta-Lactamases / genetics*

Substances

  • Anti-Bacterial Agents
  • beta-lactamase KPC-2
  • beta-Lactamases