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Trends in Incidence of Carbapenem-Resistant Enterobacterales in 7 US Sites, 2016─2020.
Duffy, Nadezhda; Li, Rongxia; Czaja, Christopher A; Johnston, Helen; Janelle, Sarah J; Jacob, Jesse T; Smith, Gillian; Wilson, Lucy E; Vaeth, Elisabeth; Lynfield, Ruth; O'Malley, Sean; Vagnone, Paula Snippes; Dumyati, Ghinwa; Tsay, Rebecca; Bulens, Sandra N; Grass, Julian E; Pierce, Rebecca; Cassidy, P Maureen; Hertzel, Heather; Wilson, Christopher; Muleta, Daniel; Taylor, Jacquelyn; Guh, Alice Y.
Afiliação
  • Duffy N; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Li R; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Czaja CA; Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, Colorado, USA.
  • Johnston H; Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, Colorado, USA.
  • Janelle SJ; Division of Disease Control and Public Health Response, Colorado Department of Public Health and Environment, Denver, Colorado, USA.
  • Jacob JT; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Smith G; Georgia Emerging Infections Program, Atlanta, Georgia, USA.
  • Wilson LE; Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
  • Vaeth E; Georgia Emerging Infections Program, Atlanta, Georgia, USA.
  • Lynfield R; Atlanta Veterans Affairs Medical Center, Decatur, Georgia, USA.
  • O'Malley S; Maryland Department of Health, Infectious Disease Epidemiology and Outbreak Response Bureau, Baltimore, Maryland, USA.
  • Vagnone PS; Maryland Department of Health, Infectious Disease Epidemiology and Outbreak Response Bureau, Baltimore, Maryland, USA.
  • Dumyati G; Minnesota Department of Health, Saint Paul, Minnesota, USA.
  • Tsay R; Minnesota Department of Health, Saint Paul, Minnesota, USA.
  • Bulens SN; Minnesota Department of Health, Saint Paul, Minnesota, USA.
  • Grass JE; NewYork Emerging Infections Program at the University of Rochester Medical Center, Rochester, New York, USA.
  • Pierce R; NewYork Emerging Infections Program at the University of Rochester Medical Center, Rochester, New York, USA.
  • Cassidy PM; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Hertzel H; Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
  • Wilson C; Public Health Division, Oregon Health Authority, Portland, Oregon, USA.
  • Muleta D; Public Health Division, Oregon Health Authority, Portland, Oregon, USA.
  • Taylor J; Public Health Division, Oregon Health Authority, Portland, Oregon, USA.
  • Guh AY; Tennessee Department of Health, Nashville, Tennessee, USA.
Open Forum Infect Dis ; 10(12): ofad609, 2023 Dec.
Article em En | MEDLINE | ID: mdl-38130598
ABSTRACT

Background:

We described changes in 2016─2020 carbapenem-resistant Enterobacterales (CRE) incidence rates in 7 US sites that conduct population-based CRE surveillance.

Methods:

An incident CRE case was defined as the first isolation of Escherichia coli, Klebsiella spp., or Enterobacter spp. resistant to ≥1 carbapenem from a sterile site or urine in a surveillance area resident in a 30-day period. We reviewed medical records and classified cases as hospital-onset (HO), healthcare-associated community-onset (HACO), or community-associated (CA) CRE based on healthcare exposures and location of disease onset. We calculated incidence rates using census data. We used Poisson mixed effects regression models to perform 2016─2020 trend analyses, adjusting for sex, race/ethnicity, and age. We compared adjusted incidence rates between 2016 and subsequent years using incidence rate ratios (RRs) and 95% confidence intervals (CIs).

Results:

Of 4996 CRE cases, 62% were HACO, 21% CA, and 14% HO. The crude CRE incidence rate per 100 000 was 7.51 in 2016 and 6.08 in 2020 and was highest for HACO, followed by CA and HO. From 2016 to 2020, the adjusted overall CRE incidence rate decreased by 24% (RR, 0.76 [95% CI, .70-.83]). Significant decreases in incidence rates in 2020 were seen for HACO (RR, 0.75 [95% CI, .67-.84]) and CA (0.75 [.61-.92]) but not for HO CRE.

Conclusions:

Adjusted CRE incidence rates declined from 2016 to 2020, but changes over time varied by epidemiologic class. Continued surveillance and effective control strategies are needed to prevent CRE in all settings.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: Open Forum Infect Dis Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos