Prevalence and Risk Factors for Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in Patients with Stroke

Han, Yong Hyun; Bae, Min Joon; Hur, Yang Rok; Hwang, Kihun

doi:10.12786/bn.2019.12.e16

Cited by 2 publications

(4 citation statements)

References 35 publications

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“…The worldwide prevalence of CRE varies depending on the region and country, and the association between increased CRE prevalence and antibiotic use can differ depending on hospital settings and local factors. 7 17 18 The number of days of antibiotic therapy is independently associated with CRE acquisition. 17 19 …”

Section: Discussionmentioning

confidence: 99%

“… 7 17 18 The number of days of antibiotic therapy is independently associated with CRE acquisition. 17 19 …”

Section: Discussionmentioning

confidence: 99%

“…The conversion rate of CRE colonization to infection was confirmed to be 36%. 30 Various factors, such as a combination of performance status 2–4 (Eastern Cooperative Oncology Group) and CCI score ≥ 3, 31 liver disease, 32 kidney disease, 26 30 pulmonary disease, 19 and indwelling devices (vascular catheter, mechanical ventilator, Foley catheter and tracheostomy), 17 33 may contribute to CRE infection.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial Use and Carbapenem-Resistant Enterobacterales in Korea: A Nationwide Case-Control Study With Propensity Score Matching

Kwon,

Kim,

Kim

et al. 2024

J Korean Med Sci

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Background Nationwide research on the association between carbapenem-resistant Enterobacterales (CREs) and antibiotic use is limited. Methods This nested case-control study analyzed Korean National Health Insurance claims data from April 2017 to April 2019. Based on the occurrence of CRE, hospitalized patients aged ≥ 18 years were classified into CRE (cases) and control groups. Propensity scores based on age, sex, modified Charlson comorbidity score, insurance type, long-term care facility, intensive care unit stay, and acquisition of vancomycin-resistant Enterococci were used to match the case and control groups (1:3). Results After matching, the study included 6,476 participants (1,619 cases and 4,857 controls). Multivariable logistic regression analysis revealed that the utilization of broad-spectrum antibiotics, such as piperacillin/tazobactam (adjusted odds ratio [aOR], 2.178; 95% confidence interval [CI], 1.829–2.594), third/fourth generation cephalosporins (aOR, 1.764; 95% CI, 1.514–2.056), and carbapenems (aOR, 1.775; 95% CI, 1.454–2.165), as well as the presence of comorbidities (diabetes [aOR, 1.237; 95% CI, 1.061–1.443], hemiplegia or paraplegia [aOR, 1.370; 95% CI, 1.119–1.679], kidney disease [aOR, 1.312; 95% CI, 1.105–1.559], and liver disease [aOR, 1.431; 95% CI, 1.073–1.908]), were significantly associated with the development of CRE. Additionally, the CRE group had higher mortality (8.33 vs. 3.32 incidence rate per 100 person-months, P < 0.001) and a total cost of healthcare utilization per person-month (15,325,491 ± 23,587,378 vs. 5,263,373 ± 14,070,118 KRW, P < 0.001) than the control group. Conclusion The utilization of broad-spectrum antibiotics and the presence of comorbidities are associated with increasing development of CRE. This study emphasizes the importance of antimicrobial stewardship in reducing broad-spectrum antibiotic use and CRE disease burden in Korea.

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Section: Discussionmentioning

confidence: 99%

“… 7 17 18 The number of days of antibiotic therapy is independently associated with CRE acquisition. 17 19 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Antimicrobial Use and Carbapenem-Resistant Enterobacterales in Korea: A Nationwide Case-Control Study With Propensity Score Matching

Kwon,

Kim,

Kim

et al. 2024

J Korean Med Sci

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“…Global reports demonstrated variation in the dissemination of CRE such as 52.0% CRE from Vietnam with K. pneumoniae (69.0%) and E. coli (59.0%) as prevalent species [ 73 ], 12.4% CRE from Indonesia [ 74 ], 2.9% CRE from Korea [ 75 ], 77.8% CRE from India [ 76 ], 54.1% CRE from Egypt with CR K. pneumoniae (53.7%) and E. coli (27.1%) [ 77 ], 22.0% CRE from Nigeria with CR K. pneumoniae (35.9%), P. aeruginosa (30.8%) [ 78 ]. While a European cohort study reported 55.0% (944/1717) CRE [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

Estimation, Evaluation and Characterization of Carbapenem Resistance Burden from a Tertiary Care Hospital, Pakistan

et al. 2023

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Carbapenem resistance has become major concern in healthcare settings globally; therefore, its monitoring is crucial for intervention efforts to halt resistance spread. During May 2019–April 2022, 2170 clinical strains were characterized for antimicrobial susceptibility, resistance genes, replicon and sequence types. Overall, 42.1% isolates were carbapenem-resistant, and significantly associated with Klebsiella pneumoniae (K. pneumoniae) (p = 0.008) and Proteus species (p = 0.043). Carbapenemases were detected in 82.2% of isolates, with blaNDM-1 (41.1%) associated with the ICU (p < 0.001), cardiology (p = 0.042), pediatric medicine (p = 0.013) and wound samples (p = 0.041); blaOXA-48 (32.6%) was associated with the ICU (p < 0.001), cardiology (p = 0.008), pediatric medicine (p < 0.001), general surgery (p = 0.001), general medicine (p = 0.005) and nephrology (p = 0.020); blaKPC-2 (5.5%) was associated with general surgery (p = 0.029); blaNDM-1/blaOXA-48 (11.4%) was associated with general surgery (p < 0.001), and wound (p = 0.002), urine (p = 0.003) and blood (p = 0.012) samples; blaOXA-48/blaVIM (3.1%) was associated with nephrology (p < 0.001) and urine samples (p < 0.001). Other detected carbapenemases were blaVIM (3.0%), blaIMP (2.7%), blaOXA-48/blaIMP (0.1%) and blaVIM/blaIMP (0.3%). Sequence type (ST)147 (39.7%) represented the most common sequence type identified among K. pneumoniae, along with ST11 (23.0%), ST14 (15.4%), ST258 (10.9%) and ST340 (9.6%) while ST405 comprised 34.5% of Escherichia coli (E. coli) isolates followed by ST131 (21.2%), ST101 (19.7%), ST10 (16.0%) and ST69 (7.4%). Plasmid replicon types IncFII, IncA/C, IncN, IncL/M, IncFIIA and IncFIIK were observed. This is first report describing the carbapenem-resistance burden and emergence of blaKPC-2-ST147, blaNDM-1-ST340 and blaNDM-1-ST14 in K. pneumoniae isolates and blaNDM-1-ST69 and blaNDM-1/blaOXA-48-ST69 in E. coli isolates coharboring extended-spectrum beta-lactamases (ESBLs) from Pakistan.

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Prevalence and Risk Factors for Carbapenem-Resistant Enterobacteriaceae Colonization in Patients with Stroke

Cited by 2 publications

References 35 publications

Antimicrobial Use and Carbapenem-Resistant Enterobacterales in Korea: A Nationwide Case-Control Study With Propensity Score Matching

Antimicrobial Use and Carbapenem-Resistant Enterobacterales in Korea: A Nationwide Case-Control Study With Propensity Score Matching

Estimation, Evaluation and Characterization of Carbapenem Resistance Burden from a Tertiary Care Hospital, Pakistan

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