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

Varma, Muralidhar; Reddy, L. Rohit; Vandana, .; Vidyasagar, Sudha; Holla, Avinash; Bhat, Nanda Krishna

doi:10.1016/j.injms.2018.05.009

Cited by 3 publications

(2 citation statements)

References 20 publications

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“…2,21 Our study results were similar with other results in which previous exposure to any broad-spectrum antibiotic had led to CRE bacteraemia. 3,4,6,12,15,22 Our study shown that the mortality rate of patients with CRE bacteraemia was 78.4%. In a meta-analysis conducted in 2018, the CRE mortality rate ranged from 18.6-94.1%.…”

Section: Discussionmentioning

confidence: 56%

“…Similar studies on risk factors of CRE bacteraemia shown that mechanical ventilation and urinary catheter played a significant role in causing CRE bacteraemia. 3,5,12,[15][16][17][18] An indwelling devices especially CVC is an independent risk factor for developing CRE bacteraemia in a previous study. 7 Meanwhile, Rosenthal VD et al found that mechanical ventilation, CVC and indwelling urinary catheter were the main causes of device-associated nosocomial infections leading to CRE infections.…”

Section: Discussionmentioning

confidence: 76%

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Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome

Nachamuthu,

Ibrahim,

Su Min Hu

et al. 2023

imjm

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INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 76%

Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome

Nachamuthu,

Ibrahim,

Su Min Hu

et al. 2023

imjm

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Changes in the prevalence of causative pathogens isolated from severe burn patients from 2012 to 2017

Park

Seo

Choi

et al. 2020

Burns

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Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017

Kotb¹,

Lyman

Ismail

et al. 2020

Antimicrob Resist Infect Control

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Objective To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. Methods Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study using national HAI surveillance data. Setting: Egyptian hospitals participating in the HAI surveillance system. The patient population included patients admitted to the intensive care unit (ICU) in participating hospitals. Enterobacteriaceae HAI cases were Klebsiella, Escherichia coli, and Enterobacter isolates from blood, urine, wound or respiratory specimen collected on or after day 3 of ICU admission. CRE HAI cases were those resistant to at least one carbapenem. For CRE HAI cases reported during 2011–2017, a hospital-level and patient-level analysis were conducted using only the first CRE isolate by pathogen and specimen type for each patient. For facility, microbiology, and clinical characteristics, frequencies and means were calculated among CRE HAI cases and compared with carbapenem-susceptible Enterobacteriaceae HAI cases through univariate and multivariate logistic regression using STATA 13. Results There were 1598 Enterobacteriaceae HAI cases, of which 871 (54.1%) were carbapenem resistant. The multivariate regression analysis demonstrated that carbapenem resistance was associated with specimen type, pathogen, location prior to admission, and length of ICU stay. Between 2011 and 2017, there was an increase in the proportion of Enterobacteriaceae HAI cases due to CRE (p-value = 0.003) and the incidence of CRE HAIs (p-value = 0.09). Conclusions This analysis demonstrated a high and increasing burden of CRE in Egyptian hospitals, highlighting the importance of enhancing infection prevention and control (IPC) programs and antimicrobial stewardship activities and guiding the implementation of targeted IPC measures to contain CRE in Egyptian ICU’s .

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

Cited by 3 publications

References 20 publications

Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome

Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome

Changes in the prevalence of causative pathogens isolated from severe burn patients from 2012 to 2017

Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017

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