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Table 2 Studies that Evaluated CRE Incidence

From: A systematic review of the epidemiology of carbapenem-resistant Enterobacteriaceae in the United States

First Author (Year) Study Population CLSI protocol Study Period Culture type # of Infections IncidenceRate
Brennan (2014) [15] CRE Surveillance and Prevention Initiative in Michigan M100-S22 2012 09/2012–02/2013 All cultures positive for carbapenem non-susceptible K. pneumoniae or E.coli. All cases had a positive or unknown modified Hodge-Test result. Only 1 case per patient per 30-day period. 102 Per 10,000 patient-days
Overall: 1.07
Acute care: 1.01
LTAC: 2.93
East: 1.24
West: 0.52
Mid-North: 0.36
Lesho (2015) [16] Tricare, i.e.civilian component of the US military health care system M100-S20–2010 01/2005–12/2012 All CRE-positive cultures (E.coli, Klebsiella spp., Enterobacter spp.). For each year of surveillance, the first CRE-positive culture per patient was included. 368 Per 100,000 person-years
All Years: 0.487
2012: 0.394
2011: 0.528
2010: 0.672
2009: 0.607
2008: 0.439
2007: 0.424
2006: 0.490
2005: 0.335
Marquez (2013) [17] Los Angeles County M100-S20 2010 06/2010–05/2011 All cultures positive for carbapenem-resistant K. pneumoniae. Only 1 isolate allowed per patient per calendar month. 675 Per 1000 patient-days
Acute and LTAC: 0.46
LTAC only: 2.54
Acute only: 0.31
Thaden (2014) [19] Duke Infection Control Outreach Network (DICON) M100-S20 2010 (20%) sites; earlier CLSI definitions (80% sites) 01/2008–12/2012 All CRE-positive cultures. Only 1 culture was allowed per patient for the entire surveillance period. 180 Per 100,000 patient-days
2008: 0.26
2012: 1.4
Guh (2015) [18] Multi-site Gram-negative Surveillance Initiative M100-S22 2012 1/2012–12/2013 All CRE non-susceptible cultures (E.coli, Klebsiella spp., Enterobacter spp.) from a normally sterile site or urine. An incident case was defined as the first isolate from a patient per 30-day period. 599 Per 100,000 persons
2012: 2.94
2013: 2.93
  1. CLSI Clinical and Laboratory Standards Institute, CRE carbapenem-resistant Enterobacteriaceae, LTAC long-term acute-care hospital