Open forum infectious diseases · 2026
Rising Incidence of New Delhi Metallo-β-Lactamase-Producing Carbapenem-Resistant Enterobacterales, 10 US Sites, 2018-2023.
СтатьяНазвание и аннотация: Перевод в очереди
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Duffy Nadezhda, Campbell Davina, Li Rongxia, Brandenburg Joshua, Ansari Uzma, Kent Alyssa G, Nadle Joelle, Hoetzer Karlie, Johnston Helen, Driscoll Jennifer, Czaja Christopher, Maloney Meghan, Jacob Jesse T, Smith Gillian, Vaeth Elisabeth, Wilson Lucy E, Tourdot Laura, Gross Annastasia, Malley Sean O, Lynfield Ruth, Dumyati Ghinwa, Looi Hsioa Che, Tellerman Julia, Hoffman Marisa R, Flores Kristina G, Hertzel Heather, Muleta Daniel, Wilson Christopher D, Karlsson Maria, Gargis Amy S, Guh Alice Y
Аннотация
BACKGROUND: We described the changing epidemiology of New Delhi metallo-β-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) in 10 US sites conducting population-based CRE surveillance during 2018-2023.
METHODS: A CRE case was defined as the first isolation of Escherichia coli, Enterobacter spp., or Klebsiella spp. resistant to ≥1 carbapenem from a sterile site or urine in a surveillance area resident within a 30-day period. Cases were classified as healthcare-associated or community-associated. Incidence rates were calculated using census data; trends were assessed using the Mann-Kendall test. Multivariable logistic regression was used to compare NDM- and Klebsiella pneumoniae carbapenemase-producing (KPC)-CRE. A subset of isolates underwent whole-genome sequencing.
RESULTS: During 2018-2023, CRE incidence increased from 5.34 to 7.65 per 100 000 population (P = .02). NDM-CRE incidence increased from 0.07 to 0.66 per 100 000 population (P = .02); no significant trend was observed for KPC-CRE. Odds of being an NDM-CRE case were increased for community-associated versus healthcare-associated cases (adjusted odds ratio [aOR], 3.2; 95% CI, 1.98-5.17) and for cases aged 0-24 years versus ≥75 years (aOR, 3.99; 95% CI, 1.59-10.02). Genomic analysis showed diversity of sequence types among NDM- versus KPC-CRE.
CONCLUSIONS: Increases in CRE incidence appear to be driven by NDM-CRE, which are more likely than KPC-CRE to be community-associated. Continued surveillance is recommended to understand changes in epidemiology.
METHODS: A CRE case was defined as the first isolation of Escherichia coli, Enterobacter spp., or Klebsiella spp. resistant to ≥1 carbapenem from a sterile site or urine in a surveillance area resident within a 30-day period. Cases were classified as healthcare-associated or community-associated. Incidence rates were calculated using census data; trends were assessed using the Mann-Kendall test. Multivariable logistic regression was used to compare NDM- and Klebsiella pneumoniae carbapenemase-producing (KPC)-CRE. A subset of isolates underwent whole-genome sequencing.
RESULTS: During 2018-2023, CRE incidence increased from 5.34 to 7.65 per 100 000 population (P = .02). NDM-CRE incidence increased from 0.07 to 0.66 per 100 000 population (P = .02); no significant trend was observed for KPC-CRE. Odds of being an NDM-CRE case were increased for community-associated versus healthcare-associated cases (adjusted odds ratio [aOR], 3.2; 95% CI, 1.98-5.17) and for cases aged 0-24 years versus ≥75 years (aOR, 3.99; 95% CI, 1.59-10.02). Genomic analysis showed diversity of sequence types among NDM- versus KPC-CRE.
CONCLUSIONS: Increases in CRE incidence appear to be driven by NDM-CRE, which are more likely than KPC-CRE to be community-associated. Continued surveillance is recommended to understand changes in epidemiology.