{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:53:11Z","timestamp":1775580791083,"version":"3.50.1"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"8","license":[{"start":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:00:00Z","timestamp":1607558400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20013252_as1\"><jats:title>Objective:<\/jats:title><jats:p>To describe the epidemiology of carbapenem-resistant Enterobacterales (CRE) bacteriuria and to determine whether urinary catheters increase the risk of subsequent CRE bacteremia.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20013252_as2\"><jats:title>Design:<\/jats:title><jats:p>Using active population- and laboratory-based surveillance we described a cohort of patients with incident CRE bacteriuria and identified risk factors for developing CRE bacteremia within 1 year.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20013252_as3\"><jats:title>Setting:<\/jats:title><jats:p>The study was conducted among the 8 counties of Georgia Health District 3 (HD3) in Atlanta, Georgia.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20013252_as4\"><jats:title>Patients:<\/jats:title><jats:p>Residents of HD3 with CRE first identified in urine between 2012 and 2017.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20013252_as5\"><jats:title>Results:<\/jats:title><jats:p>We identified 464 patients with CRE bacteriuria (mean yearly incidence, 1.96 cases per 100,000 population). Of 425 with chart review, most had a urinary catheter (56%), and many resided in long-term care facilities (48%), had a Charlson comorbidity index &gt;3 (38%) or a decubitus ulcer (37%). 21 patients (5%) developed CRE bacteremia with the same organism within 1 year. Risk factors for subsequent bacteremia included presence of a urinary catheter (odds ratio [OR], 8.0; 95% confidence interval [CI], 1.8\u201334.9), central venous catheter (OR, 4.3; 95% CI, 1.7\u201310.6) or another indwelling device (OR, 4.3; 95% CI, 1.6\u201311.4), urine culture obtained as an inpatient (OR, 5.7; 95% CI, 1.3\u201325.9), and being in the ICU in the week prior to urine culture (OR, 2.9; 95% CI, 1.1\u20137.8). In a multivariable analysis, urinary catheter increased the risk of CRE bacteremia (OR, 5.3; 95% CI, 1.2\u201323.6).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20013252_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>In patients with CRE bacteriuria, urinary catheters increase the risk of CRE bacteremia. Future interventions should aim to reduce inappropriate insertion and early removal of urinary catheters.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.1325","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T08:22:59Z","timestamp":1607588579000},"page":"962-967","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Carbapenem-resistant Enterobacterales bacteriuria and subsequent bacteremia: A population-based study"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9924-0458","authenticated-orcid":false,"given":"Jessica R.","family":"Howard-Anderson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris W.","family":"Bower","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Elizabeth","family":"Sexton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica M.","family":"Farley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah W.","family":"Satola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse T.","family":"Jacob","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"S0899823X20013252_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit500"},{"key":"S0899823X20013252_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70054-4"},{"key":"S0899823X20013252_ref14","unstructured":"14. Standard Operating Procedure for PulseNet PFGE of Escherichia coli O157:H7, Escherichia coli non-O157 (STEC), Salmonella serotypes, Shigella sonnei and Shigella flexneri. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/pulsenet\/pdf\/ecoli-shigella-salmonella-pfge-protocol-508c.pdf. Accessed November 23, 2020."},{"key":"S0899823X20013252_ref5","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00387-11"},{"key":"S0899823X20013252_ref22","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.5651"},{"key":"S0899823X20013252_ref15","unstructured":"15. Sexton, ME. Evaluation of risk factors for invasive carbapenem-resistant Enterobacteriaceae infections and resultant mortality in Atlanta, 2011\u20132015. 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Tacconelli, E , Magrini, N. Global priority list of antibiotic-resistant bacteria to guide research, discovery and development of new antibiotics. World Health Organization website. https:\/\/www.who.int\/Medicines\/Publications\/WHO-PPL-Short_Summary_25Feb-ET_NM_WHO.Pdf?Ua=1. Accessed December 19, 2019."},{"key":"S0899823X20013252_ref23","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw282"},{"key":"S0899823X20013252_ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.12480"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20013252","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T08:01:05Z","timestamp":1628582465000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20013252\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,10]]},"references-count":29,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["S0899823X20013252"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.1325","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,10]]},"assertion":[{"value":"\u00a9 The Author(s), 2020. 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