Deaths Attributable to Carbapenem-Resistant Enterobacteriaceae Infections

• Main Authors: Matthew E. Falagas, Giannoula S. Tansarli, Drosos E. Karageorgopoulos, Konstantinos Z. Vardakas
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2014-07-01
• Series: Emerging Infectious Diseases
• Subjects: carbapenem resistance; bloodstream infection; Enterobacteriaceae; carbapenem-resistant Enterobacteriaceae; infections; Klebsiella pneumoniae
• Online Access: https://wwwnc.cdc.gov/eid/article/20/7/12-1004_article
• ISSN: 1080-6040; 1080-6059

We evaluated the number of deaths attributable to carbapenem-resistant Enterobacteriaceae by using studies from around the world published before April 9, 2012. Attributable death was defined as the difference in all-cause deaths between patients with carbapenem-resistant infections and those with carbapenem-susceptible infections. Online databases were searched, and data were qualitatively synthesized and pooled in a metaanalysis. Nine studies met inclusion criteria: 6 retrospective case–control studies, 2 retrospective cohort studies, and 1 prospective cohort study. Klebsiella pneumoniae was the causative pathogen in 8 studies; bacteremia was the only infection in 5 studies. We calculated that 26%–44% of deaths in 7 studies were attributable to carbapenem resistance, and in 2 studies, which included bacteremia and other infections, −3% and −4% of deaths were attributable to carbapenem resistance. Pooled outcomes showed that the number of deaths was significantly higher in patients with carbapenem-resistant infections and that the number of deaths attributable to carbapenem resistance is considerable.