Carbapenem and Cephalosporin Resistance Among Enterobacteriaceae in Healthcare-Associated Infections, California, USA

Kyle Rizzo; Sam Horwich-Scholefield; Erin Epson


Emerging Infectious Diseases. 2019;25(7):1389-1393. 

In This Article

Abstract and Introduction


We analyzed antimicrobial susceptibility test results reported in healthcare-associated infections by California hospitals during 2014–2017. Approximately 3.2% of Enterobacteriaceae reported in healthcare-associated infections were resistant to carbapenems and 26.9% were resistant to cephalosporins. The proportion of cephalosporin-resistant Escherichia coli increased 7% (risk ratio 1.07, 95% CI 1.04–1.11) per year during 2014–2017.


The Centers for Disease Control and Prevention (CDC) identified carbapenem-resistant Enterobacteriaceae (CRE) as an urgent public health threat and extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae as a serious public health threat.[1] Antimicrobial-resistant pathogens, such as CRE, can spread across regions when infected or colonized patients transfer between healthcare facilities without infection control measures in place to prevent transmission.[2] Therefore, tracking regional changes in antimicrobial resistance (AMR) is essential to inform public health prevention and containment strategies.