The epidemiology and risk factor of carbapenem-resistant enterobacteriaceae colonization and infections: Case control study in a single institute in Japan

Background. We conducted this case-control study to determine the risk factors and treatment outcome of infections due to carbapenem resistant Enterobacteriaceae in our institution.Methods. This is a matched case-control study of patients with infection due to carbapenem resistant Enterobacteriaceae (CRE) and carbapenem susceptible Enterobacteriaceae (CSE), from Riyadh, Saudi Arabia, between March 2012 and December 2013.Results. During this period, 29 cases and 58 controls were studied. The mean ages of the cases (55.4 years) and controls (54.7 years) were similar (p=0.065). Cases had higher mean Charlson comorbidity index (CCI) (3.1) than controls (1.9),p=0.026. Several factors contributed to infection among the studied population. Prior uses of piperacillin-tazobactam, a carbapenem, a quinolone, and metronidazole were significantly associated with CRE infections. Nine of the cases died compared with 7 of the controls,p=0.031. Mortality was associated with advanced age, the presence of comorbidities, ICU stay, and receipt of invasive procedures.Conclusions. Infections due to CRE resulted in a significantly increased mortality. Combination antibiotic therapy was associated with reduced mortality. Properly designed randomized controlled studies are required to better characterize these findings.

Download Full-text

Risk factors and 30-day mortality for carbapenem-resistant Enterobacteriaceae infection, a case control study

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.09.061 ◽

2020 ◽

Vol 101 ◽

pp. 8-9

Author(s):

Z.Y. Taye ◽

M. Makmor Bakry ◽

N. Bahari

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Carbapenem Resistant ◽

Control Study ◽

Carbapenem Resistant Enterobacteriaceae

Download Full-text

Risk factors of carbapenem-resistant Enterobacteriaceae infection and colonisation: a Malaysian tertiary care hospital based case-control study

The Journal of the Royal College of Physicians of Edinburgh ◽

10.4997/jrcpe.2021.107 ◽

2021 ◽

Vol 51 (1) ◽

pp. 24-30

Author(s):

Chuan Chuah ◽

◽

Yasmin Gani ◽

Benedict Sim ◽

Suresh Chidambaram

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Univariate Analysis ◽

Tertiary Care ◽

Case Control ◽

High Morbidity ◽

Care Hospital ◽

Carbapenem Resistant ◽

Control Study ◽

Carbapenem Resistant Enterobacteriaceae

Background Carbapenem-resistant Enterobacteriaceae (CRE) infection has become a major challenge to clinicians. The aim of this study is to identify the risk factors of acquiring CRE to guide more targeted screening for hospital admissions. Methods This is a retrospective case-control study (ratio 1:1) where a patient with CRE infection or colonisation was matched with a control. The control was an individual who tested negative for CRE but was a close contact of a patient testing positive and was admitted at the same time and place. Univariate and multivariate statistical analyses were done. Results The study included 154 patients. The majority of the CRE was Klebsiella species (83%). From univariate analysis, the significant risk factors were having a history of indwelling devices (OR: 2.791; 95% CI: 1.384–5.629), concomitant other MDRO (OR: 2.556; 95% CI: 1.144–5.707) and hospitalisation for more than three weeks (OR: 2.331; 95% CI: 1.163–4.673). Multivariate analysis showed that being unable to ambulate on admission (adjusted OR: 2.345; 95% CI: 1.170–4.699) and antibiotic exposure (adjusted OR: 3.515; 95% CI: 1.377–8.972) were independent predictors. The in-hospital mortality rate of CRE infection was high (64.5%). CRE acquisition resulted in prolonged hospitalisation (median=35 days; P<0.001). Conclusion CRE infection results in high morbidity and mortality. On top of the common risk factors, patients with mobility restriction, prior antibiotic exposures and hospitalisation for more than three weeks should be prioritised in the screening strategy to control the spread of CRE.

Download Full-text

Risk Factors for Recurrence of Carbapenem-Resistant Enterobacteriaceae Carriage: Case-Control Study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2015.82 ◽

2015 ◽

Vol 36 (8) ◽

pp. 936-941 ◽

Cited By ~ 29

Author(s):

Yossi Bart ◽

Mical Paul ◽

Orna Eluk ◽

Yuval Geffen ◽

Galit Rabino ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Case Control ◽

Positive Sample ◽

Carrier Status ◽

Carbapenem Resistant ◽

Risk Factors For Recurrence ◽

Control Study ◽

Carbapenem Resistant Enterobacteriaceae

BACKGROUNDThe natural history of carbapenem-resistant Enterobacteriaceae (CRE) carriage and the timing and procedures required to safely presume a CRE-free status are unclear.OBJECTIVETo determine risk factors for recurrence of CRE among presumed CRE-free patients.METHODSCase-control study including CRE carriers in whom CRE carriage presumably ended, following at least 2 negative screening samples on separate days. Recurrence of CRE carriage was identified through clinical samples and repeated rectal screening in subsequent admissions to any healthcare facility in Israel. Patients with CRE recurrence (cases) were compared with recurrence-free patients (controls). The duration of follow-up was 1 year for all surviving patients.RESULTSIncluded were 276 prior CRE carriers who were declared CRE-free. Thirty-six persons (13%) experienced recurrence of CRE carriage within a year after presumed eradication. Factors significantly associated with CRE recurrence on multivariable analysis were the time in months between the last positive CRE sample and presumed eradication (odds ratio, 0.94 [95% CI, 0.89–0.99] per month), presence of foreign bodies at the time of presumed eradication (4.6 [1.64–12.85]), and recurrent admissions to healthcare facilities during follow-up (3.15 [1.05–9.47]). The rate of CRE recurrence was 25% (11/44) when the carrier status was presumed to be eradicated 6 months after the last known CRE-positive sample, compared with 7.5% (10/134) if presumed to be eradicated after 1 year.CONCLUSIONSWe suggest that the CRE-carrier status be maintained for at least 1 year following the last positive sample. Screening of all prior CRE carriers regardless of current carriage status is advised.Infect. Control Hosp. Epidemiol. 2015;36(8):936–941

Download Full-text