Emergence and expansion of carbapenem resistant enterobacterales in the Western Cape Province, South Africa

This study examines the epidemiology of carbapenem resistant Enterobacterales (CRE) carriage and clinical infection episodes in South African healthcare facilities from 2016 to 2020. The study identified 2242 CRE episodes, with Klebsiella species predominating. The majority of CRE episodes were recorded in central hospitals. In-hospital mortality rates were 26.9% for clinical episodes and 6.4% for carriage episodes. Factors associated with in-hospital mortality included female sex, adult patients, CRE isolation from a sterile specimen, and more than three days between hospital admission and specimen collection. The study concludes that infection control interventions must be strengthened to reduce CRE transmission and infection risks.