Predictors of carbapenem-resistant Enterobacteriaceae (CRE) strains in patients with COVID-19 in the ICU ward: a retrospective case–control study

• Published in: Journal of international medical research Vol. 50; no. 10; p. 3000605221129154
• Main Authors: Vlad, Nicoleta-Dorina, Cernat, Roxana Carmen, Carp, Sorina, Mitan, Romelia, Dumitru, Andrei, Nemet, Codruța, Voidăzan, Septimiu, Rugină, Sorin, Dumitru, Irina-Magdalena
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.10.2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibiotics; Carbapenem-Resistant Enterobacteriaceae; Carbapenems - pharmacology; Carbapenems - therapeutic use; Case-Control Studies; Coronaviruses; COVID-19; CRE bacteria; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Humans; Intensive Care Units; Retrospective Clinical Research Report; Retrospective Studies; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; COVID-19; Carbapenem-resistant Enterobacteriaceae; risk factors
• ISSN: 0300-0605; 1473-2300; 1473-2300
• DOI: 10.1177/03000605221129154

Objective To identify carbapenem-resistant Enterobacteriaceae (CRE) in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) and to determine whether they had different risk factors for the acquisition of CRE than patients without COVID-19. Methods This retrospective single-centre, case–control study enrolled patients with and without COVID-19. The demographic, clinical, infection, colonization and mortality data were compared between the two groups. Results A total of 38 patients with COVID-19 and 26 patients without COVID-19 were enrolled. The majority of isolates detected in COVID-19 patients were Klebsiella spp. Leukopenia at admission (odds ratio [OR] 4.70; 95% confidence interval [CI] 1.37, 16.10), invasive mechanical ventilation (OR 5.74; 95% CI 1.07, 30.63), carbapenem treatment (OR 5.09; 95% CI 1.21, 21.27) and corticosteroid treatment (OR 7.06; 95% CI 1.53, 32.39) were independent risk factors for CRE acquisition in COVID-19 patients. Intensive care unit (ICU) mortality was significantly higher in COVID-19 patients compared with patients without COVID-19 (OR 20.62; 95% CI 5.50, 77.23). Length of ICU stay increased the risk of death in patients with COVID-19 (subdistribution hazard ratio 3.81; 95% CI 1.33, 10.92). Conclusion CRE strains were more common in patients with COVID-19 and they had different risks for CRE compared with patients without COVID-19.