{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Shrestha R"],"funding":["National Institute of Allergy and Infectious Diseases","NIAID NIH HHS","National Institutes of Health","National Institute of General Medical Sciences","NIGMS NIH HHS"],"pagination":["2763-2771"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9989732"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["77(10)"],"pubmed_abstract":["<h4>Background</h4>Community-acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat.<h4>Methods</h4>In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured &gt;48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling.<h4>Results</h4>CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was the most common CRE species, of these 184/204 (90%) were carbapenemase producers (CPKP). The top three genetic markers in random forest models were kpi_SA15, fimE, and kpfC. Of these, kpi_SA15 (which encodes a chaperone/usher system) was positively associated (OR 3.14, 95% CI 1.13-8.87, P = 0.026), and kpfC negatively associated (OR 0.21, 95% CI 0.05-0.72, P = 0.015) with CA-CPKP.<h4>Conclusions</h4>Ten percent of CDC-defined CRE were CA. The true proportion of CA-CRE in hospitalized patients is likely lower as patients may have had unrecorded prior healthcare exposure. The kpi_SA15 operon was associated with the CA phenotype."],"journal":["The Journal of antimicrobial chemotherapy"],"pubmed_title":["Characteristics of community-acquired carbapenem-resistant Enterobacterales."],"pmcid":["PMC9989732"],"funding_grant_id":["R01 AI134637","UM1 AI104681","P01 AI152999","R01AI143910","UM1AI104681","R01 AI143910","K24 AI121296","R01 AI148342","T32GM086330","T32 GM086330"],"pubmed_authors":["Huskins WC","Dinh A","Salata RA","Rydell KB","Revolinski S","Wang M","Hanson B","Herc E","Rudin SD","Hill C","Domitrovic TN","Patel R","Kaye KS","Mediavilla JR","Patel G","Evans S","Ostrowsky B","Fries BC","Doi Y","Shropshire W","Chen L","Cober E","van Duin D","Fowler VG","Eilertson B","Han JH","Gallagher JC","Dhar S","Manca C","Weston G","Shrestha R","Anderson DJ","Arias CA","Chambers HF","Earley M","Kim A","Grant M","Lok JJ","Jacob JT","Dai W","Satlin MJ","Hujer KM","Luterbach C","Kreiswirth BN","Desai S","Wong D","Richter SS","Salata R","Abbo LM","Luterbach CL","Komarow L","Perez F","Banerjee R","Kalayjian RC","Marshall SH","Tran TT","Garcia-Diaz J","Panesso D","Bonomo RA","Arias R","Hujer AM","Wortmann G","Paterson DL","Farrell JJ","Anderson D","Garner OB","MDRO Investigators"],"additional_accession":[]},"is_claimable":false,"name":"Characteristics of community-acquired carbapenem-resistant Enterobacterales.","description":"<h4>Background</h4>Community-acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat.<h4>Methods</h4>In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured &gt;48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling.<h4>Results</h4>CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was the most common CRE species, of these 184/204 (90%) were carbapenemase producers (CPKP). The top three genetic markers in random forest models were kpi_SA15, fimE, and kpfC. Of these, kpi_SA15 (which encodes a chaperone/usher system) was positively associated (OR 3.14, 95% CI 1.13-8.87, P = 0.026), and kpfC negatively associated (OR 0.21, 95% CI 0.05-0.72, P = 0.015) with CA-CPKP.<h4>Conclusions</h4>Ten percent of CDC-defined CRE were CA. The true proportion of CA-CRE in hospitalized patients is likely lower as patients may have had unrecorded prior healthcare exposure. The kpi_SA15 operon was associated with the CA phenotype.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Sep","modification":"2026-05-28T11:25:12.933Z","creation":"2025-02-19T03:26:14.359Z"},"accession":"S-EPMC9989732","cross_references":{"pubmed":["36179278"],"doi":["10.1093/jac/dkac239"]}}