{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T06:13:28Z","timestamp":1790662408561,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>The incidence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing since 2008, with Gyeonggi Province in South Korea being particularly vulnerable due to its large number of healthcare facilities. This study examines the trends of CRE occurrence in Gyeonggi Province over the past four years and the epidemiological characteristics of the infected patients. Patients with positive CRE blood cultures admitted to healthcare facilities in Gyeonggi Province from January 2018 to December 2021 were evaluated in this study. Risk factors for CRE-related death were analyzed using data from patients who died within 30 days of the last blood sampling. Older adults aged 70 years and above constituted the majority of patients with CRE bacteremia. Antibiotic use did not significantly affect mortality risk. Non-survivors were more common in tertiary hospitals and intensive care units and included patients with hypertension, malignant tumors, and multiple underlying diseases. Klebsiella pneumoniae was the most common CRE strain, with Klebsiella pneumoniae carbapenemase being the predominant carbapenemase. Our study suggests the endemicity of CRE in Gyeonggi Province and highlights the increasing isolation of CRE strains in South Korean long-term care hospitals within the province. Further, infection control measures and government support specific to each healthcare facility type are crucial.<\/jats:p>","DOI":"10.3390\/antibiotics12081286","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T09:27:48Z","timestamp":1691141268000},"page":"1286","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiology of Carbapenem-Resistant Enterobacteriaceae Bacteremia in Gyeonggi Province, Republic of Korea, between 2018 and 2021"],"prefix":"10.3390","volume":"12","author":[{"given":"Seung Hye","family":"Lee","sequence":"first","affiliation":[{"name":"Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon-si 16508, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0441-4107","authenticated-orcid":false,"given":"Chan Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Gyeonggi Infectious Disease Control Center, Health Bureau, Gyeonggi Provincial Government, Suwon-si 16508, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hee Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun Hee","family":"Park","sequence":"additional","affiliation":[{"name":"Pyeongchang County Health and Medical Center, Pyeongchang-gun 25374, Gangwon-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8181-1195","authenticated-orcid":false,"given":"Su Ha","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Medicine, SoonChunHyang University, Cheonan-si 31151, Chungcheongnam-do, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1093\/cid\/cix893","article-title":"Carbapenemase-producing Organisms: A Global Scourge","volume":"66","author":"Bonomo","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/S1473-3099(17)30753-3","article-title":"Discovery, Research, and Development of New Antibiotics: The Who Priority List of Antibiotic Resistant Bacteria and Tuberculosis","volume":"18","author":"Tacconelli","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","first-page":"3790","article-title":"Molecular characteristic analysis and antimicrobial resistance of carbapenem-resistant Enterobacteriaceae (CRE) isolates in the Republic of Korea, 2017\u20132020","volume":"14","author":"Joo","year":"2021","journal-title":"Wkly. Health Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107","DOI":"10.4167\/jbv.2020.50.2.107","article-title":"Prevalence of Carbapenem-resistant Enterobacteriaceae in Seoul, Korea","volume":"50","author":"Park","year":"2020","journal-title":"J. Bacteriol. Virol."},{"key":"ref_5","first-page":"1977","article-title":"Distributions of Carbapenem-resistant Enterobacteriaceae (CRE) in Korea, 2018","volume":"12","author":"Go","year":"2019","journal-title":"Public Health Wkly. Rep."},{"key":"ref_6","first-page":"2360","article-title":"Characteristics of Carbapenem-resistant Enterobacteriaceae (CRE) in the Republic of Korea, 2021","volume":"15","author":"Jeong","year":"2022","journal-title":"Public Health Wkly. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e303","DOI":"10.3346\/jkms.2020.35.e303","article-title":"Positivity of Carbapenemase-Producing Enterobacteriaceae in Patients Following Exposure Within Long-Term Care Facilities in Seoul, Korea","volume":"35","author":"Park","year":"2020","journal-title":"J. Korean Med. Sci."},{"key":"ref_8","first-page":"43","article-title":"Outbreak of Carbapenem-Resistant Enterobacteriaceae (Cre) In a Long-Term Acute Care Facility in the Republic of Korea","volume":"27","author":"Jung","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.jhin.2019.11.015","article-title":"Outbreak of Carbapenemase-Producing Enterobacteriaceae Associated with a Contaminated Water Dispenser and Sink Drains in the Cardiology Units of a Korean Hospital","volume":"104","author":"Jung","year":"2020","journal-title":"J. Hosp. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"601968","DOI":"10.3389\/fcimb.2021.601968","article-title":"Carbapenem-Resistant Enterobacterales in Long-Term Care Facilities: A Global and Narrative Review","volume":"11","author":"Chen","year":"2021","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_11","unstructured":"Centers for Disease Control and Prevention (2023, August 01). Facility Guidance for Control of Carbapenem-Resistant Enterobacteriaceae (CRE)\u2014November 2015 Update CRE Toolkit, Available online: https:\/\/www.cdc.gov\/hai\/pdfs\/cre\/cre-guidance-508.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13756-017-0259-z","article-title":"Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: Guidance from the European Centre for Disease Prevention and Control","volume":"6","author":"Magiorakos","year":"2017","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Gomides, M.D.A., Fontes, A.M.S., Silveira, A.O.S.M., Matoso, D.C., Ferreira, A.L., and Sadoyama, G. (2022). The importance of active surveillance of carbapenem-resistant Enterobacterales (CRE) in colonization rates in critically ill patients. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0262554"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"101871","DOI":"10.1016\/j.eclinm.2023.101871","article-title":"Risk factors for infections caused by carbapenem-resistant Enterobacterales: An international matched case-control-control study (EURECA)","volume":"57","author":"Paniagua","year":"2023","journal-title":"E ClinicalMedicine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6907","DOI":"10.2147\/IDR.S390635","article-title":"Mortality-Related Risk Factors and Novel Antimicrobial Regimens for Carbapenem-Resistant Enterobacteriaceae Infections: A Systematic Review","volume":"15","author":"Hu","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1017\/ice.2016.153","article-title":"Risk Factors for Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (Cp-Cre) Acquisition Among Contacts of Newly Diagnosed Cp-Cre Patients","volume":"37","author":"Braun","year":"2016","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1093\/infdis\/jiw282","article-title":"The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace","volume":"215","author":"Logan","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"175","DOI":"10.4266\/acc.2021.00409","article-title":"Identification and Infection Control of Carbapenem-Resistant Enterobacterales in Intensive Care Units","volume":"36","author":"Yi","year":"2021","journal-title":"Acute Crit. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.3346\/jkms.2019.34.e140","article-title":"Prevalence and Risk Factors of Carbapenem-Resistant Enterobacteriaceae Acquisition in an Emergency Intensive Care Unit in a Tertiary Hospital in Korea: A Case-Control Study","volume":"34","author":"Kang","year":"2019","journal-title":"J. Korean Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1179\/2047773215Y.0000000004","article-title":"Risk factors for carbapenem-resistant Klebsiella pneumoniae infection\/colonization and predictors of mortality: A retrospective study","volume":"109","author":"Jiao","year":"2015","journal-title":"Pathog. Glob. Health."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"166","DOI":"10.3947\/ic.2016.48.3.166","article-title":"Carbapenem-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Single Community-Based Hospital in Korea","volume":"48","author":"Lee","year":"2016","journal-title":"Infect. Chemother."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1086\/671270","article-title":"Prevalence and Risk Factors for Acquisition of Carbapenem-Resistant Enterobacteriaceae in the Setting of Endemicity","volume":"34","author":"Swaminathan","year":"2013","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1007\/s00134-008-1288-0","article-title":"Diabetes Mellitus Is an Independent Risk Factor for ICU-Acquired Bloodstream Infections","volume":"35","author":"Michalia","year":"2009","journal-title":"Intensive Care Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jama.2015.12480","article-title":"Epidemiology of Carbapenem-resistant Enterobacteriaceae in 7 US Communities, 2012\u20132013","volume":"314","author":"Guh","year":"2015","journal-title":"JAMA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e255","DOI":"10.3346\/jkms.2018.33.e255","article-title":"The Infinity War: How to Cope with Carbapenem-Resistant Enterobacteriaceae","volume":"33","author":"Yoo","year":"2018","journal-title":"J. Korean Med. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e01882-17","DOI":"10.1128\/AAC.01882-17","article-title":"Epidemiology of Carbapenem-Resistant Enterobacteriaceae Infections: Report from the China CRE Network","volume":"62","author":"Zhang","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Suay-Garc\u00eda, B., and P\u00e9rez-Gracia, M.T. (2019). Present and Future of Carbapenem-resistant Enterobacteriaceae (CRE) Infections. Antibiotics, 8.","DOI":"10.3390\/antibiotics8030122"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Onorato, L., Sarnelli, B., D\u2019Agostino, F., Signoriello, G., Trama, U., D\u2019Argenzio, A., Montemurro, M.V., and Coppola, N. (2022). Epidemiological, Clinical and Microbiological Characteristics of Patients with Bloodstream Infections Due to Carbapenem-Resistant K. Pneumoniae in Southern Italy: A Multicentre Study. Antibiotics, 11.","DOI":"10.3390\/antibiotics11050633"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ijantimicag.2017.03.012","article-title":"Carbapenem-Resistant Enterobacteriaceae in the Community: A Scoping Review","volume":"50","author":"Kelly","year":"2017","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_30","unstructured":"(2017). Guidelines for the Prevention and Control of Carbapenem-Resistant Enterobacteriaceae, Acinetobacter Baumannii and Pseudomonas Aeruginosa in Health Care Facilities, World Health Organization."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1017\/ice.2021.70","article-title":"Coronavirus Disease 2019 (COVID-19) Pandemic, Central-Line-Associated Bloodstream Infection (CLABSI), and Catheter-Associated Urinary Tract Infection (CAUTI): The Urgent Need to Refocus on Hardwiring Prevention Efforts","volume":"43","author":"Fakih","year":"2022","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jacamr\/dlac130","article-title":"The Impact of COVID-19 on Multidrug-Resistant Organisms Causing Healthcare-Associated Infections: A Narrative Review","volume":"5","author":"Witt","year":"2022","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e34","DOI":"10.1093\/cid\/ciac684","article-title":"The Disproportionate Impact of Coronavirus Disease 2019 (COVID-19) Pandemic on Healthcare-Associated Infections in Community Hospitals: Need for Expanding the Infectious Disease Workforce","volume":"76","author":"Advani","year":"2023","journal-title":"Clin. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jhin.2016.10.006","article-title":"Control of Carbapenemase-Producing Enterobacteriaceae Outbreaks in Acute Settings: An Evidence Review","volume":"95","author":"French","year":"2017","journal-title":"J. Hosp. Infect."},{"key":"ref_35","unstructured":"(2022). Guidelines for the Management of Healthcare-Associated Infectious Diseases, Korea Disease Control and Prevention Agency (KDCA). Available online: https:\/\/www.kdca.go.kr\/board\/board.es?mid=a20507020000&bid=0019."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/8\/1286\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:25:44Z","timestamp":1760127944000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/8\/1286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,4]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["antibiotics12081286"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics12081286","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,4]]}}}