Epidemiology and risk factors for carbapenem-resistant Enterobacteriaceae colonisation and infections: case-controlled study from an academic medical center in a southern area of China

• Published in: Pathogens and disease Vol. 77; no. 4
• Main Authors: Fang, Lili, Lu, Xiaohui, Xu, Heping, Ma, Xiaobo, Chen, Yilan, Liu, Yue, Hong, Guolin, Liang, Xianming
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.06.2019
• Subjects: Academic Medical Centers; Adolescent; Adult; Aged; Aged, 80 and over; Antibiotics; Carbapenem-Resistant Enterobacteriaceae - isolation & purification; Carbapenemase; Carrier State - epidemiology; Carrier State - microbiology; Case-Control Studies; Child; Child, Preschool; China; Colonization; Control methods; CRE bacteria; Culture; Enterobacteriaceae; Enterobacteriaceae - classification; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - epidemiology; Epidemiology; Female; Geography; Health care facilities; Humans; Infant; Infant, Newborn; Infections; Klebsiella; Lung diseases; Male; Middle Aged; Prevalence; Public health; Resistance factors; Respiratory tract; Retrospective Studies; Risk analysis; Risk Factors; Statistical analysis; Young Adult; China; carbapenem-resistant; retrospective; risk factors; case-controlled; Enterobacteriaceae; KPC
• ISSN: 2049-632X; 2049-632X
• DOI: 10.1093/femspd/ftz034

While the emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) and related infections pose serious threats to global public health, the epidemiology and associated risk factors remain poorly understood and vary by geography. In a case-controlled retrospective study, we examined the prevalence, patient background and risk factors for CRE colonisation and infections, and all patient-derived CRE from January 2015 to January 2017. Isolated carbapenem-susceptible Enterobacteriaceae (CSE) from 2875 enrolled patients were randomly selected during the study. CRE colonisation and infections detection rates were 47/2875 (1.6%). Respiratory tract specimens were most frequently seen in 20/47 (42.6%) cases. Klebsiella pneumoniae was the main isolate in 35/47 (74.5%) CRE. As for carbapenemase, KPC-2-producing bacteria was most frequently detected in 38/47 (80.9%) Enterobacteriaceae. No underlying conditions (P = 0.004), pulmonary diseases (P = 0.018) and no antibiotics used prior to culture within 30 days (P < 0.001) were statistically significant between the CRE and CSE groups. Klebsiellapneumoniae was the main isolate of CRE. The blaKPC-2 was the predominant CRE gene. Underlying conditions especially pulmonary diseases and antibiotics used prior to culture within 30 days represented key risk factors for acquisition of CRE.