{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:23:14Z","timestamp":1768555394186,"version":"3.49.0"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1219,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:sec id=\"S0195941700050256_abs1\"><jats:title>Background.<\/jats:title><jats:p>Carbapenem-resistant <jats:italic>Enterobacteriaceae<\/jats:italic> (CRE) are rapidly emerging in hospitals in the United States and are posing a significant threat. To better understand the transmission dynamics and the acquisition of resistant strains, a thorough analysis of epidemiologic and molecular characteristics was performed.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050256_abs2\"><jats:title>Methods.<\/jats:title><jats:p>CRE isolated at Detroit Medical Center were analyzed from September 2008 to September 2009. <jats:italic>bla<\/jats:italic><jats:sub>KPC<\/jats:sub> genes were investigated by polymerase chain reaction (PCR), and repetitive extragenic palindromic PCR (rep-PCR) was used to determine genetic similarity among strains. Epidemiologic and outcomes analyses were performed.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050256_abs3\"><jats:title>Results.<\/jats:title><jats:p>Ninety-two unique patient CRE isolates were recovered. Sixty-eight strains (74%) were <jats:italic>Klebsiella pneumoniae<\/jats:italic>, 7 were <jats:italic>Klebsiella oxytoca<\/jats:italic>, 15 were <jats:italic>Enterobacter<\/jats:italic> species, and 2 were <jats:italic>Escherichia coli<\/jats:italic>. Fifteen isolates (16%) were resistant to Colistin, 14 (16%) were resistant to tigecycline, and 2 were resistant to all antimicrobials tested. The mean \u00b1 standard deviation age of patients was 63 \u00b1 2 years. Sixty patients (68%) were admitted to the hospital from long-term care facilities. Only 70% of patients received effective antimicrobial therapy when infection was suspected, with a mean time to appropriate therapy of 120 \u00b1 23 hours following sample culturing. The mean length of hospitalization after sample culturing was 18.6 \u00b1 2.5 days. Of 57 inpatients, 18 (32%) died in the hospital. Independent predictors for mortality were intensive care unit stay (odds ratio [OR], 15.8; <jats:italic>P<\/jats:italic> = .003) and co-colonization with CRE and either <jats:italic>Acinetobacter baumannii<\/jats:italic> or <jats:italic>Pseudomonas aeruginosa<\/jats:italic> (OR, 17.2; <jats:italic>P<\/jats:italic> = .006). Among <jats:italic>K. pneumoniae<\/jats:italic> CRE, rep-PCR revealed 2 genetically related strains that comprised 70% and 20% of isolates, respectively.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700050256_abs4\"><jats:title>Conclusions.<\/jats:title><jats:p>In this large U.S. cohort of patients with CRE infection, which reflects the modern continuum of medical care, co-colonization with CRE and <jats:italic>A. baumannii<\/jats:italic> or <jats:italic>P. aeruginosa<\/jats:italic> was associated with increased mortality. Two predominant clones of <jats:italic>K. pneumoniae<\/jats:italic> accounted for the majority of cases of CRE infection.<\/jats:p><\/jats:sec>","DOI":"10.1086\/661597","type":"journal-article","created":{"date-parts":[[2011,8,9]],"date-time":"2011-08-09T15:57:24Z","timestamp":1312905444000},"page":"861-871","source":"Crossref","is-referenced-by-count":63,"title":["Outcomes and Genetic Relatedness of Carbapenem-Resistant <i>Enterobacteriaceae<\/i> at Detroit Medical Center"],"prefix":"10.1017","volume":"32","author":[{"given":"Dror","family":"Marchaim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teena","family":"Chopra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Perez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kayoko","family":"Hayakawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul R.","family":"Lephart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchitha","family":"Bheemreddy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Blunden","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Hujer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Rudin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryann","family":"Shango","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jastin","family":"Varkey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Slim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farah","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diixa","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting-Yi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"Pogue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossein","family":"Salimnia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorabh","family":"Dhar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Bonomo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith S.","family":"Kaye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700050256_ref024","doi-asserted-by":"publisher","DOI":"10.3201\/eid1307.070187"},{"key":"S0195941700050256_ref028","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq191"},{"key":"S0195941700050256_ref023","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn547"},{"key":"S0195941700050256_ref005","doi-asserted-by":"publisher","DOI":"10.1086\/648451"},{"key":"S0195941700050256_ref017","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000298158.12101.41"},{"key":"S0195941700050256_ref027","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01020-07"},{"key":"S0195941700050256_ref012","first-page":"256","article-title":"Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities","volume":"58","year":"2009","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"S0195941700050256_ref010","doi-asserted-by":"crossref","first-page":"2911","DOI":"10.1001\/jama.2008.896","article-title":"Carbapenem-resistant Enterobacteriaceae. a potential threat","volume":"300","author":"Schwaber","year":"2008","journal-title":"JAMA"},{"key":"S0195941700050256_ref016","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02301-09"},{"key":"S0195941700050256_ref001","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.4.1151-1161.2001"},{"key":"S0195941700050256_ref013","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01020-10"},{"key":"S0195941700050256_ref007","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq108"},{"key":"S0195941700050256_ref002","doi-asserted-by":"publisher","DOI":"10.1086\/592412"},{"key":"S0195941700050256_ref011","doi-asserted-by":"publisher","DOI":"10.1086\/649865"},{"key":"S0195941700050256_ref009","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2007.07.024"},{"key":"S0195941700050256_ref029","doi-asserted-by":"publisher","DOI":"10.1086\/648077"},{"key":"S0195941700050256_ref004","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp327"},{"key":"S0195941700050256_ref014","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00627-10"},{"key":"S0195941700050256_ref021","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing: 19th Informational Supplement","year":"2009"},{"key":"S0195941700050256_ref025","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02534-10"},{"key":"S0195941700050256_ref003","doi-asserted-by":"publisher","DOI":"10.1086\/421495"},{"key":"S0195941700050256_ref015","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2009.01.010"},{"key":"S0195941700050256_ref019","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0195941700050256_ref006","doi-asserted-by":"publisher","DOI":"10.1086\/651097"},{"key":"S0195941700050256_ref008","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00299-07"},{"key":"S0195941700050256_ref020","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"S0195941700050256_ref018","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.291.6493.432"},{"key":"S0195941700050256_ref022","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00008-10"},{"key":"S0195941700050256_ref026","doi-asserted-by":"publisher","DOI":"10.1086\/600391"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700050256","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T08:40:24Z","timestamp":1722242424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700050256\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,9]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2011,9]]}},"alternative-id":["S0195941700050256"],"URL":"https:\/\/doi.org\/10.1086\/661597","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,9]]}}}