Major articleRisk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: A matched case-control study
Section snippets
Study design and patients
This case-control study was conducted at Severance Hospital in Seoul, Korea, a 2000-bed tertiary care medical center. In this retrospective study, microbiology laboratory databases were reviewed to identify all clinical cultures positive for CRE between January 2006 and December 2010. All identified patients were studied, and their medical charts were reviewed. For patients with multiple episodes of infection with E coli, only data relevant to the first episode were collected and analyzed.
For
Number of patients with CRE during the study period
Between January 2006 to December 2010, a total of 171 patients were enrolled in this study, including 57 cases with CRE and 114 controls with carbapenem-susceptible E coli. The 2 groups were matched for the site and the date of E coli isolation. During the 5-year study period, CRE was isolated from 57 patients, including 6 in 2006, 9 in 2007, 18 in 2008, 17 in 2009, and 7 in 2010.
Demographic and clinical characteristics of subjects
The demographics and characteristics of the 2 groups are shown in Table 1. The mean patient age was 62.56 years in
Discussion
Currently, carbapenems are the most potent agents for the treatment of serious infections with Enterobacteriaceae species because of their broad spectrum of antibacterial activity and their high stability to hydrolysis by most β-lactamases, including ESBLs and AmpC cephalosporinases.16 However, the increasing use of carbapenems has led to the emergence of carbapenem-resistant Enterobacteriaceae species, including E coli, which is becoming an important therapeutic problem in clinical fields.17,
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2020, Journal of Hospital InfectionCitation Excerpt :One review, evaluating the effectiveness of the control measures, reported that 52 of the 98 publications included (53%) have implemented cohorting of patients and/or HCWs [37]. Several studies have evaluated risk factors for carriage, acquisition, and infection of CPE in both acute care settings and LCTFs [52–59]. A recent meta-analysis aimed to determine risk factors for acquisition among hospitalized patients.
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2018, Journal of Infection and ChemotherapyCitation Excerpt :This criterion in Japan does not relate to whether isolate produces any carbapenemase or not. It has already been reported that prior antibiotic use, prior hospital stay, exposure to healthcare facilities, vascular device, biliary drainage catheter, tracheostomy, transferring to intensive care unit (ICU), abdominal invasive procedure, chemotherapy and radiation therapy were risk factors for patients to have CRE [18–21]. Exposures to healthcare facilities, to fluoroquinolones and carbapenems were independent risk factors for CRE infection [22–25].
Risk factors for acquisition of OXA-48-producing Klebsiella pneumonia among contact patients: a multicentre study
2018, Journal of Hospital InfectionCitation Excerpt :This may be because, whereas the Katz index indicates functional status as a measurement of a patient's ability to perform daily activities, it does not specifically take into account the burden of care. Several case–control studies analysed risk factors for CPE acquisition [9,20,24–26]. However, many of them did not take into account the reservoir of CPE, i.e. the patients' gastrointestinal carriage, contributing to what is usually described as the ‘colonization pressure’.
Shifts in antimicrobial consumption and infection rates before and during a piperacillin/tazobactam shortage
2017, Journal of Global Antimicrobial ResistanceCitation Excerpt :These data, whilst seemingly contradictory, support a multifactorial role in the development and mitigation of CDI outbreaks associated with antimicrobial use rates. The role of expanded use of carbapenems on CRE emergence has been well described [8]. Whilst rates of these infections were low during the study period, the current data demonstrate a near doubling in the emergence of the resistant pathogens that parallels a doubling of meropenem use over the same period.
Effectiveness of cefmetazole versus meropenem for invasive urinary tract infections caused by extended-spectrum β-lactamase-producing Escherichia coli
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This work was supported by BioNano Health-Guard Research Center funded by the Ministry of Science, ICT, and Future Planning of Korea as a Global Frontier Project (Grant H-GUARD_2013M3A6B2078953).
Conflict of interest: None to report.