Half of patients with a deadly resistance gene died in NY study
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Key takeaways:
- Half of patients in a New York study with an NDM-positive drug-resistant infection died.
- The overall mortality rate for patients with carbapenemase-producing organisms was 33%.
LOS ANGELES — One-third of patients with a carbapenemase-producing organism died, according to a study conducted at nearly a dozen New York hospitals.
The mortality rate was even higher — around 50% — among patients with an infection that harbored a particular antimicrobial resistance gene, blaNDM, researchers reported at IDWeek.
Gram-negative bacteria have been on the rise, specifically carbapenemase-producing organisms (CPOs), Kirby An, PharmD, an infectious disease pharmacy resident at the Northwell-Long Island Jewish Medical Center in New Hyde Park, New York, said during a press briefing ahead of the conference.
In the new study, blaNDM was the most common carbapenemase resistance gene detected in CPO-positive blood and urine samples.
“These genes confer resistance to a number of different antibiotics,” An said, adding that “depending on the type of gene that is conferred, it converts resistance to some of the even new antibiotics — and most particularly with the NDM gene.”
An and colleagues conducted a multicenter study of 121 patients hospitalized at one of 10 hospitals whose blood or urine cultures tested positive for a CPO between January 2021 and December 2023. The researchers used PCR results to identify carbapenemase genes in the blood cultures and assessed phenotypic carbapenemase production in the urine specimens using a lateral flow immunoassay, they said.
Among the 71 CPO-positive blood cultures and 50 CPO-positive urine cultures, Klebiella pneumoniae was the most common CPO in both the blood and urine samples, An and colleagues found. UTIs were the most common source of CPO bacteremia, according to the study.
The researchers reported that among carbapenemase genes detected in the cultures, the NDM gene was isolated in 39% of blood samples and 46% of urine samples.
Overall, 30-day readmission rates were 16% for blood infections and 50% for urine infections. Despite clinical intervention, 42% of people with CPO bacteremia died in 2022 and 33% died in 2023. The mortality rates for patients with the NDM-positive CPOs was 54% in 2022 and 50% in 2023.
An and colleagues said timely identification of CPOs and resistant genes is “crucial” for adjusting treatment regimens because, although the study revealed that the median time for treatment after a blood culture was 3.9 hours, it took 16 hours after urine cultures.
“There is still a lot to be studied in terms of treatment for these different organisms, and a lot to still understand,” An said. “Hopefully, the next step is to utilize the fact that we can identify these genes and look into different treatment options to figure out the best ways to treat our patients.”
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An K, et al. Abstract 102. Presented at IDWeek; Oct. 16-19, 2024; Los Angeles.
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