Epidemiology of Infections by Carbapenemase-Producing Enterobacteriaceae in a Tertiary Hospital

Healthcare-Associated Infections (HAIs) caused by carbapenem-resistant Enterobacteriaceae (CRE) represent a serious public health problem, associated with high morbidity and mortality rates. These CRE carry various carbapenemase-encoding genes, such as blaKPC, and display regionally variable epidemiological profiles. This study aimed to evaluate the epidemiological profile of hospitalized patients with HAIs caused by CRE in a tertiary hospital in southern Brazil. This is a retrospective cohort study, with data collected from electronic medical records of hospitalized patients in the period 2021 to 2023. Patients diagnosed with HAIs caused by Enterobacteriaceae were included. The statistical analysis considered a significance level of 5% (p < 0.05). The sample comprised 57 patients, with 29 men (50.88%) and 28 women (49.12%). Caucasian ethnicity was the most prevalent (84.21%), and the predominant infectious focus was urinary (59.6%). Most infections (80.70%) were caused by Klebsiella pneumoniae, with the blaKPC gene being the main resistance mechanism identified (95.65%). Of a total of 19 deaths, 15 were patients infected with Klebsiella spp. Among the variables analyzed, acute kidney injury (AKI) was the only factor with statistical significance for mortality (p = 0.031). COVID infection, the need for dialysis, polymyxin resistance, and the presence of the blaKPC gene were not determining factors for death (p > 0.05). The study demonstrated an epidemiological profile of HAIs caused by CRE in a tertiary hospital, with predominance of Klebsiella pneumoniae and the blaKPC gene as the main resistance mechanism, although the presence of this gene was not shown to be determinant for mortality. Acute kidney injury emerged as a significant factor for the outcome of death, while other factors such as COVID infection, dialysis, and polymyxin resistance did not show this association.