{"doi":"10.17615/5jtr-vg15","title":"Characteristics of community-Acquired carbapenem-resistant Enterobacterales","abstract":"Background: Community-Acquired carbapenem-resistant Enterobacterales (CA-CRE) are an important threat. Methods: In CRACKLE-2, we defined patients with CA-CRE as admitted from home, without pre-existing conditions, and a positive culture within 48 h of admission. Healthcare-Associated CRE (HA-CRE) were those with the lowest likelihood of community acquisition, not admitted from home and cultured >48 h after admission. Specific genetic markers in carbapenemase-producing Klebsiella pneumoniae were evaluated through random forest modelling. Results: CA-CRE and HA-CRE were detected in 83 (10%) and 208 (26%) of 807 patients. No significant differences were observed in bacterial species or strain type distribution. K. pneumoniae (204/291, 70%) was the most common CRE species, of these 184/204 (90%) were carbapenemase producers (CPKP). The top three genetic markers in random forest models were kpi_SA15, fimE, and kpfC. Of these, kpi_SA15 (which encodes a chaperone/usher system) was positively associated (OR 3.14, 95% CI 1.13-8.87, P = 0.026), and kpfC negatively associated (OR 0.21, 95% CI 0.05-0.72, P = 0.015) with CA-CPKP. Conclusions: Ten percent of CDC-defined CRE were CA. The true proportion of CA-CRE in hospitalized patients is likely lower as patients may have had unrecorded prior healthcare exposure. The kpi_SA15 operon was associated with the CA phenotype.","journal":"UNC Libraries","year":2024,"id":498825,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9399,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1323894,"name":"Arias C.A.","orcid":null,"position":1,"is_corresponding":false},{"id":1345889,"name":"Michael Earley","orcid":null,"position":2,"is_corresponding":false},{"id":281106,"name":"Robert A. Salata","orcid":"0000-0001-8464-0918","position":3,"is_corresponding":false},{"id":234480,"name":"Lauren Komarow","orcid":null,"position":4,"is_corresponding":false},{"id":393167,"name":"Deverick J. Anderson","orcid":"0000-0001-6882-5496","position":5,"is_corresponding":false},{"id":1345391,"name":"Del P. Wong","orcid":"0000-0002-8481-3417","position":6,"is_corresponding":false},{"id":433718,"name":"Liming Chen","orcid":"0000-0002-8129-9563","position":7,"is_corresponding":false},{"id":1345890,"name":"Luterbach C.L.","orcid":null,"position":8,"is_corresponding":false},{"id":1345392,"name":"R. Shrestha","orcid":"0000-0002-3140-6623","position":9,"is_corresponding":false},{"id":1345891,"name":"Jacob J.T.","orcid":null,"position":10,"is_corresponding":false},{"id":380572,"name":"Wei Dai","orcid":"0000-0003-1650-1590","position":11,"is_corresponding":false},{"id":1345892,"name":"Rydell K.B.","orcid":null,"position":12,"is_corresponding":false},{"id":618259,"name":"Erica Herc","orcid":"0000-0002-9069-6659","position":13,"is_corresponding":false},{"id":1275223,"name":"van Duin D.","orcid":null,"position":14,"is_corresponding":false},{"id":1345387,"name":"Georgie Weston","orcid":"0000-0003-3019-7150","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:09:42.181447Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}