Epidemiology and risk factors for carbapenem-resistant Enterobacteriaceae colonisation and infections: case-controlled study from an academic medical center in a southern area of China

Lili Fang; Xiaohui Lu; Heping Xu; Xiaobo Ma; Yilan Chen; Yue Liu; Guolin Hong; Xianming Liang

doi:10.1093/femspd/ftz034

Epidemiology and risk factors for carbapenem-resistant Enterobacteriaceae colonisation and infections: case-controlled study from an academic medical center in a southern area of China

Pathog Dis. 2019 Jun 1;77(4):ftz034. doi: 10.1093/femspd/ftz034.

Authors

Lili Fang^{1

2}, Xiaohui Lu^{1

2}, Heping Xu^{1

2}, Xiaobo Ma^{1

2}, Yilan Chen¹, Yue Liu¹, Guolin Hong^{1

2}, Xianming Liang^{3

4}

Affiliations

¹ Department of Clinical Laboratory, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen 361003, China.
² School of Public Health, Xiamen University, Xiamen 361102, China.
³ Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen 361004, China.
⁴ Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen 361004, China.

PMID: 31281931
DOI: 10.1093/femspd/ftz034

Abstract

Objective: While the emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) and related infections pose serious threats to global public health, the epidemiology and associated risk factors remain poorly understood and vary by geography.

Methods: In a case-controlled retrospective study, we examined the prevalence, patient background and risk factors for CRE colonisation and infections, and all patient-derived CRE from January 2015 to January 2017. Isolated carbapenem-susceptible Enterobacteriaceae (CSE) from 2875 enrolled patients were randomly selected during the study.

Results: CRE colonisation and infections detection rates were 47/2875 (1.6%). Respiratory tract specimens were most frequently seen in 20/47 (42.6%) cases. Klebsiella pneumoniae was the main isolate in 35/47 (74.5%) CRE. As for carbapenemase, KPC-2-producing bacteria was most frequently detected in 38/47 (80.9%) Enterobacteriaceae. No underlying conditions (P = 0.004), pulmonary diseases (P = 0.018) and no antibiotics used prior to culture within 30 days (P < 0.001) were statistically significant between the CRE and CSE groups.

Conclusion: Klebsiellapneumoniae was the main isolate of CRE. The blaKPC-2 was the predominant CRE gene. Underlying conditions especially pulmonary diseases and antibiotics used prior to culture within 30 days represented key risk factors for acquisition of CRE.

Keywords: Enterobacteriaceae; KPC; carbapenem-resistant; case-controlled; retrospective; risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Academic Medical Centers
Adolescent
Adult
Aged
Aged, 80 and over
Carbapenem-Resistant Enterobacteriaceae / isolation & purification*
Carrier State / epidemiology*
Carrier State / microbiology
Case-Control Studies
Child
Child, Preschool
China
Enterobacteriaceae / classification
Enterobacteriaceae / isolation & purification*
Enterobacteriaceae Infections / epidemiology*
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Prevalence
Retrospective Studies
Risk Factors
Young Adult