Carbapenemase-producing Enterobacteriaceae in an inpatient post-acute care facility: Impact on time to functional recovery

• Published in: Annals of physical and rehabilitation medicine Vol. 65; no. 5; p. 101621
• Main Authors: Loukili, Noureddine Henoun, Jusot, Jean-François, Allart, Etienne, Celani, Gael, Perrin, Agnes, Gaillot, Olivier, Blanchard, Anne, Pardessus, Vinciane, Thevenon, André, Tiffreau, Vincent
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Masson SAS 01.09.2022; Elsevier Masson
• Series: Annals of Physical and Rehabilitation Medicine
• Subjects: Carbapenemase-producing enterobacteriaceae; Functional independence measure; Life Sciences; Nosocomial; Post-acute care; Post-acute care; LOS; Functional independence measure; pac; RU; Carbapenemase-producing enterobacteriaceae; Nosocomial; CPE; FIM; TTFR; PVC; enterobacteriaceae; Carbapenemase-producing
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2021.101621

•Carbapenemase-producing Enterobacteriaceae was monitored in post-acute care.•The functional independence measure was measured on admission and discharge.•Functional recovery was defined on the basis of this difference.•The time to functional recovery (TTFR) was estimated by a survival analysis approach.•Carbapenemase-producing Enterobacteriaceae-positive status is associated with a longer time to functional recovery. The carriage of carbapenemase-producing Enterobacteriaceae (CPE) might lengthen the time to functional recovery (TTFR) for inpatients in post-acute care (PAC) units. We aimed to assess the impact of CPE carriage on TTFR in a PAC facility. This 2-year retrospective cohort study included 20 CPE-positive patients and 54 CPE-negative patients admitted to 3 PAC units (general, orthopaedic and neurological rehabilitation units) in a teaching hospital from January 2017 to December 2019. Potential risk factors and demographic data were collected from patients’ medical records, the French national hospital discharge database, and the hospital's CPE surveillance database. Functional recovery was defined as the median difference in functional independence measure (FIM) between admission and discharge from each unit. Survival analysis and multiple Cox regression models were used to predict the TTFR and identify factors associated with functional recovery. The overall median [interquartile range] TTFR was 50 days [36–66]. Longer median TTFR was associated with CPE carriage (63 vs 47 days in the CPE-negative group; adjusted hazard ratio (aHR) 0.35, 95% CI 0.13–0.97) and presence of a peripheral venous catheter (aHR 3.51, 1.45–8.46); shorter TTFR was associated with admission to an orthopaedic versus general rehabilitation unit (aHR 3.11, 1.24–7.82). CPE carriage in inpatient PAC facilities was associated with long TTFR. Further studies are needed to explore the mechanisms involved in these adverse events and to identify possible preventive measures.