AI Article Synopsis
- This study examined how common carbapenem-resistant Enterobacterales (CRE) infections and colonizations are in intensive care unit (ICU) patients and what factors contribute to their presence at admission and during the hospital stay.
- Conducted across 24 ICUs in Anhui, China, the research involved screening patients and applying statistical analysis to identify risk factors linked to CRE colonization/infection.
- Findings revealed that 5.9% of patients had CRE at admission and 8.5% acquired it during their ICU stay, with several identified risk factors including prior hospital transfers, recent antibiotic exposure, and prolonged ICU stays.
Article Abstract
Objectives: This study aimed to investigate the prevalence and risk factors for carbapenem-resistant Enterobacterales colonisation/infection at admission and acquisition among patients admitted to the intensive care unit.
Research Methodology/design: A prospective and multicentre study.
Setting: This study was conducted in 24 intensive care units in Anhui, China.
Main Outcome Measures: Demographic and clinical data were collected, and rectal carbapenem-resistant Enterobacterales colonisation was detected by active screening. Multivariate logistic regression models were used to analyse factors associated with colonisation/infection with carbapenem-resistant Enterobacterales at admission and acquisition during the intensive care unit stay.
Results: There were 1133 intensive care unit patients included in this study. In total, 5.9% of patients with carbapenem-resistant Enterobacterales colonisation/infection at admission, and of which 56.7% were colonisations. Besides, 8.5% of patients acquired carbapenem-resistant Enterobacterales colonisation/infection during the intensive care stay, and of which 67.6% were colonisations. At admission, transfer from another hospital, admission to an intensive care unit within one year, colonisation/infection/epidemiological link with carbapenem-resistant Enterobacterales within one year, and exposure to any antibiotics within three months were risk factors for colonisation/infection with carbapenem-resistant Enterobacterales. During the intensive care stay, renal disease, an epidemiological link with carbapenem-resistant Enterobacterales, exposure to carbapenems and beta-lactams/beta-lactamase inhibitors, and intensive care stay of three weeks or longer were associated with acquisition.
Conclusion: The prevalence of colonisation/infection with carbapenem-resistant Enterobacterales in intensive care units is of great concern and should be monitored systematically. Particularly for the 8.5% prevalence of carbapenem-resistant Enterobacterales acquisition during the intensive care stay needs enhanced infection prevention and control measures in these setting. Surveillance of colonisation/infection with carbapenem-resistant Enterobacterales at admission and during the patient's stay represents an early identification tool to prevent further transmission of carbapenem-resistant Enterobacterales.
Implications For Clinical Practice: Carbapenem-resistant Enterobacterales colonization screening at admission and during the patient's stay is an important tool to control carbapenem-resistant Enterobacterales spread in intensive care units.
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Source |
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| http://dx.doi.org/10.1016/j.iccn.2023.103491 | DOI Listing |
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