{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T04:48:00Z","timestamp":1791002880264,"version":"4.1.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Allergan, Inc","award":["CAZ-IT-21"],"award-info":[{"award-number":["CAZ-IT-21"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5R01AI090155"],"award-info":[{"award-number":["5R01AI090155"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002384"],"award-info":[{"award-number":["UL1TR002384"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA008748"],"award-info":[{"award-number":["P30CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients with bacteremia due to carbapenem-resistant Enterobacterales (CRE) experience delays until appropriate therapy and high mortality rates. Rapid molecular diagnostics for carbapenemases and new \u03b2-lactam\/\u03b2-lactamase inhibitors may improve outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted an observational study of patients with CRE bacteremia from 2016 to 2018 at 8 New York and New Jersey medical centers and assessed center-specific clinical microbiology practices. We compared time to receipt of active antimicrobial therapy and mortality between patients whose positive blood cultures underwent rapid molecular testing for the Klebsiella pneumoniae carbapenemase (KPC) gene (blaKPC) and patients whose cultures did not undergo this test. CRE isolates underwent antimicrobial susceptibility testing by broth microdilution and carbapenemase profiling by whole-genome sequencing. We also assessed outcomes when ceftazidime-avibactam and polymyxins were used as targeted therapies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 137 patients with CRE bacteremia, 89 (65%) had a KPC-producing organism. Patients whose blood cultures underwent blaKPC PCR testing (n = 51) had shorter time until receipt of active therapy (median: 24 vs 50\u2005hours; P = .009) compared with other patients (n = 86) and decreased 14-day (16% vs 37%; P = .007) and 30-day (24% vs 47%; P = .007) mortality. blaKPC PCR testing was associated with decreased 30-day mortality (adjusted odds ratio: .37; 95% CI: .16\u2013.84) in an adjusted model. The 30-day mortality rate was 10% with ceftazidime-avibactam monotherapy and 31% with polymyxin monotherapy (P = .08).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a KPC-endemic area, blaKPC PCR testing of positive blood cultures was associated with decreased time until appropriate therapy and decreased mortality for CRE bacteremia, and ceftazidime-avibactam is a reasonable first-line therapy for these infections.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac354","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T19:14:39Z","timestamp":1651605279000},"page":"2066-2075","source":"Crossref","is-referenced-by-count":88,"title":["Impact of a Rapid Molecular Test for <i>Klebsiella pneumoniae<\/i> Carbapenemase and Ceftazidime-Avibactam Use on Outcomes After Bacteremia Caused by Carbapenem-Resistant Enterobacterales"],"prefix":"10.1093","volume":"75","author":[{"given":"Michael J","family":"Satlin","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine , New York, New York , USA"},{"name":"Department of Pathology and Laboratory Medicine, Weill Cornell Medicine , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Discovery and Innovation, Hackensack Meridian Health , Nutley, New Jersey , USA"},{"name":"Department of Medical Sciences, Hackensack Meridian School of Medicine , Nutley, New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Gomez-Simmonds","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center , New York, New York , 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Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J","family":"Sperber","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Hackensack Meridian School of Medicine , Nutley, New Jersey , USA"},{"name":"Division of Infectious Diseases, Department of Medicine, Hackensack University Medical Center , Hackensack, New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela C","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell , Manhasset, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Eilertson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, State University of New York Downstate , Brooklyn, New York , 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Immunology, and Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey , USA"},{"name":"Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hackensack University Medical Center , Hackensack, New Jersey , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Juretschko","sequence":"additional","affiliation":[{"name":"Department of Pathology, Northwell Health , Manhasset, New York , 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