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Effect of carbapenem resistance on outcomes of bloodstream infection caused by Enterobacteriaceae in low-income and middle-income countries (PANORAMA): A multinational prospective cohort study

The Lancet Infectious Diseases May 30, 2019

Stewardson AJ, et al. - Researchers sought to determine how carbapenem resistance influences mortality and length of hospital stay among inpatients in low-income and middle-income countries with bloodstream infection caused by Enterobacteriaceae. They recruited 297 patients (174 with carbapenem-susceptible Enterobacteriaceae (CSE) and 123 with carbapenem-resistant Entero-bacteriaceae (CRE) bloodstream infections) in the PANORAMA study, a multinational prospective cohort study at tertiary hospitals in Bangladesh, Colombia, Egypt, Ghana, India, Lebanon, Nepal, Nigeria, Pakistan, and Vietnam. Patients with CSE bloodstream infection had crude mortality of 20% (35 of 174 patients) vs 35% (43 of 123 patients) for patients with CRE bloodstream infection. Furthermore, they noted an increased length of hospital stay, increased probability of in-hospital mortality, and decreased probability of discharge alive in correlation with carbapenem resistance.

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