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

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  • Additional Information
    • Source:
      Publisher: SAGE Publications Country of Publication: England NLM ID: 101144324 Publication Model: Print Cited Medium: Internet ISSN: 2042-8189 (Electronic) Linking ISSN: 14782715 NLM ISO Abbreviation: J R Coll Physicians Edinb Subsets: MEDLINE
    • Publication Information:
      Publication: 2022- : [London] : SAGE Publications
      Original Publication: Edinburgh : Royal College of Physicians of Edinburgh, c2002-
    • Subject Terms:
    • Abstract:
      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.
      Competing Interests: No conflict of interests declared
    • Contributed Indexing:
      Keywords: Enterobacteriaceae; carbapenem-resistant; epidemiology; infection control; risk factors
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20210420 Date Completed: 20210728 Latest Revision: 20210728
    • Publication Date:
      20240104
    • Accession Number:
      10.4997/JRCPE.2021.107
    • Accession Number:
      33877130