Infections by carbapenemase-producing enterobacteriaceae in a department of urology. A new challenge

Abstract

Objectives: To analyse infections by carbapenemase-producing enterobacteriaceae (CPE) and describe the characteristics and potential risk factors associated with patients of a department of urology.

Material and methods: Observational and retrospective study. The inclusion criterion was hospitalisation in our department of Urology between August 2013 and December 2016. We analysed those patients who were positive for CPE in at least 1 culture. We reviewed their baseline characteristics, risk factors and variables such as the presence of previous urinary tract infections, subsequent readmissions, the microorganism, type of CPE, treatment, origin (hospital or community) and mortality.

Results: Of the 5,657 patients who met the inclusion criterion, a CPE was isolated in 12 cases. CPE infections represented 3.6% of all healthcare-associated infections and 9.7% of those caused by enterobacteria. The analysed factors associated with CPE infection in our series were the presence of urinary catheters (100%), undergoing surgery (58.3%), previous ICU admission (8.3%) and immunosuppression (16.6%). In terms of mortality, 8.3% of the patients who presented CPE infection died during hospitalisation.

Conclusions: Approximately 10% of enterobacteria present a carbapenemase-resistance pattern in urological patients in our setting. Carrying a urinary catheter and/or undergoing surgery are risk factors associated with the development of these infections in urological patients in our setting. CPE infections increase morbidity and mortality.

Keywords: Carbapenemase-producing enterobacteriaceae; Enterobacterias productoras de carbapenemasas; Factores de riesgo; Healthcare-associated infections; Infecciones relacionadas con la asistencia sanitaria; Risk factors; Urology; Urología.