Predictors of Rectal Carriage of Carbapenem-Resistant Enterobacteriaceae (CRE) among Patients with Known CRE Carriage at Their Next Hospital Encounter

2011 ◽  
Vol 32 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Vered Schechner ◽  
Tali Kotlovsky ◽  
Jalal Tarabeia ◽  
Meital Kazma ◽  
David Schwartz ◽  
...  
Keyword(s):  
Screen Test ◽  
Healthcare Facility ◽  
Negative Control ◽  
Time Interval ◽  
Healthcare Facilities ◽  
Positive Screen ◽  
Carbapenem Resistant ◽  
History Of ◽  
Control Study ◽  
Carbapenem Resistant Enterobacteriaceae

Background.Carbapenem-resistant Enterobacteriaceae (CRE) are important extremely drug-resistant pathogens that have emerged during the past decade. Early identification and isolation of carriers are key components of an effective infection control strategy in healthcare facilities. Very little is known about the natural history of CRE carriage. We aimed to determine the predictors of a positive CRE rectal screen test among patients with known CRE carriage screened at their next hospital encounter.Methods.A case-control study was conducted. Sixty-six patients who tested positive for CRE carriage were surveyed for CRE rectal carriage at the next hospital encounter; screen-positive patients were compared with screen-negative control patients. Data were extracted from the patients' medical records and from the hospital computerized database.Results.Twenty-three case patients and 43 control patients were identified. Predictors for a positive CRE rectal carriage test were (1) prior fluoroquinolone use (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.10–16.6), (2) admission from an institution or another hospital (OR, 4.04; 95% CI, 1.33–12.37), and (3) time interval less than or equal to 3 months since the first positive CRE test (OR, 3.59; 95% CI, 1.24–10.37). Among patients with no predictor variables, the likelihood of having a positive screen test at the next hospital encounter was 1/7. If they had at least 1 predictor, the likelihood increased to 1/2.Conclusions.Prior fluoroquinolone use, transfer from another healthcare facility, and admission less than or equal to 3 months since the first CRE isolation are predictors of persistent CRE rectal carriage. These predictors can be used in designing CRE prevention strategies.

scholarly journals 532. Can Saccharomyces boulardii Therapy Be Effective in Decolonizing Rectal Carbapenem-Resistant Enterobacteriaceae (CRE) Colonization?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S255-S256
Author(s):  
Oguz Resat Sipahi ◽  
Gunel Quliyeva ◽  
Feriha Cilli ◽  
Nilgun Deniz Kucukler ◽  
Demet Dikis ◽  
...  
Keyword(s):  
Susceptibility Testing ◽  
Rectal Swab ◽  
Saccharomyces Boulardii ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Promising Tool ◽  
Carbapenem Resistant ◽  
History Of ◽  
Vitek 2 ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background CRE are globally important pathogens associated with significant morbidity and mortality. The problem of carrying CRE may continue to create a problem in discharged cases in the community. Saccharomyces boulardii sachet therapy (SBST) is reported to cause decolonization in several MDR bacteria carriers. Herein, it is aimed to present the decolonizing rates of rectal CRE colonized cases after SBST treatment. Methods The study period was August 2018–March 2019. Inclusion criteria were: (i) age >18, (ii) receiving Saccharomyces boulardii 250 mg sachets q12h for 7 days, (iii) being proven CRE carrier on rectal swab culture (RSC) up to 5 days period before SBST. The first repeated RSC was performed 3–5 days after the end of SBST. Data were retrieved from the hospital electronic database. Cases with three consecutive weekly performed negative RSC were considered to be decolonized. RSC were processed according to CDC protocol; briefly, the swab was inoculated into 10 mL of trypticase soy broth (bioMérieux Inc., Marcy-l’Étoile, France) with the addition of one 10-μg ertapenem disk (Oxoid, Altrincham, UK) and incubated at 35°C for 18–20 h. The next day, after vortexing, 100 μL of the inoculum was subcultured (8) onto chromID CARBA agar plates (bioMérieux) and incubated at 35°C for 18–20 h. Suspected CRE colonies on chromID CARBA (blue/green to blue/gray in color) were identified by the VITEK MS system (bioMérieux). Susceptibility testing of the isolates was performed with the VITEK 2 system (bioMérieux). Isolates were tested for their resistance phenotypes to imipenem, ertapenem, and meropenem by E-test (bioMérieux). The results were interpreted according to the EUCAST criteria. Results Fifteen cases [2 women, mean age 60.6 ± 18.3 (min. 18–max. 83)] fulfilled the inclusion criteria. All had a history of carbapenem usage. Five cases (33%) had three consequent negative RSC after SBST and were considered to be decolonized. Twelve cases were receiving concomitant antibiotic during SBST (10 carbapenem based regimens). Three cases who received no concomitant antibiotic were decolonized. Conclusion SBST may be a promising tool for decolonizing CRE carriers. These data need to be validated in larger cohorts preferably via randomized-controlled trials. Disclosures All authors: No reported disclosures.

scholarly journals Nosocomial Pathogens: An In-Depth Analysis of the Vectorial Potential of Cockroaches

2019 ◽  
Vol 4 (1) ◽  
pp. 14 ◽  
Author(s):  
Eric S. Donkor
Keyword(s):  
Nosocomial Infections ◽  
Social Consequences ◽  
Antibiotic Resistant ◽  
Nosocomial Pathogens ◽  
Healthcare Facilities ◽  
Carbapenem Resistant ◽  
Depth Analysis ◽  
Healthcare Associated ◽  
Carbapenem Resistant Enterobacteriaceae

Nosocomial or healthcare-associated infections are regarded as the most frequent adverse event that threatens patients’ safety and has serious economic and social consequences. Cockroach infestation is common in many hospitals, especially in the developing world. Common nosocomial pathogens isolated from cockroaches include Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae. Cockroaches also harbor epidemiologically significant antibiotic-resistant organisms, such as carbapenem-resistant Enterobacteriaceae, which complicate nosocomial infections. Therefore, cockroaches constitute an important vector for nosocomial pathogens, and there should be zero tolerance for their presence in healthcare facilities. This paper aims to elucidate the possible role of cockroaches in nosocomial infections by reviewing the relevant research publications.

Statewide Surveillance of Carbapenem-Resistant Enterobacteriaceae in Michigan

2014 ◽  
Vol 35 (4) ◽  
pp. 342-349 ◽  
Author(s):  
Brenda M. Brennan ◽  
Joseph R. Coyle ◽  
Dror Marchaim ◽  
Jason M. Pogue ◽  
Martha Boehme ◽  
...  
Keyword(s):  
Data Collection ◽  
Acute Care ◽  
Multidrug Resistant ◽  
Fourth Generation ◽  
Public Health Issue ◽  
Resistant Organism ◽  
Recent Infection ◽  
Healthcare Facilities ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Background.Carbapenem-resistant Enterobacteriaceae (CRE) are clinically challenging, threaten patient safety, and represent an emerging public health issue. CRE reporting is not mandated in Michigan.Methods.The Michigan Department of Community Health–led CRE Surveillance and Prevention Initiative enrolled 21 facilities (17 acute care and 4 long-term acute care facilities) across the state. Baseline data collection began September 1, 2012, and ended February 28, 2013 (duration, 6 months). Enrolled facilities voluntarily reported cases of Klebsiella pneumoniae and Escherichia coli according to the surveillance algorithm. Patient demographic characteristics, laboratory testing, microbiology, clinical, and antimicrobial information were captured via standardized data collection forms. Facilities reported admissions and patient-days each month.Results.One-hundred two cases over 957,220 patient-days were reported, resulting in a crude incidence rate of 1.07 cases per 10,000 patient-days. Eighty-nine case patients had test results positive for K. pneumoniae, whereas 13 had results positive for E. coli. CRE case patients had a mean age of 63 years, and 51% were male. Urine cultures (61%) were the most frequently reported specimen source. Thirty-five percent of cases were hospital onset; sixty-five percent were community onset (CO), although 75% of CO case patients reported healthcare exposure within the previous 90 days. Cardiovascular disease, renal failure, and diabetes mellitus were the most frequently reported comorbid conditions. Common ris k factors included surgery within the previous 90 days, recent infection or colonization with a multidrug-resistant organism, and recent exposures to antimicrobials, especially third- or fourth-generation cephalosporins.Conclusions.CRE are found throughout Michigan healthcare facilities. Implementing a regional, coordinated surveillance and prevention initiative may prevent CRE from becoming hyperendemic in Michigan.

Risk factors for carbapenem resistant enterobacteriaceae in a teritiary hospital—A case control study

2018 ◽  
Vol 9 (4) ◽  
pp. 178-183 ◽  
Author(s):  
Muralidhar Varma ◽  
L. Rohit Reddy ◽  
Vandana ◽  
Sudha Vidyasagar ◽  
Avinash Holla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Control Study ◽  
Carbapenem Resistant Enterobacteriaceae
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