A case-control study to identify risk factors associated with carbapenem resistant Enterobacteriaceae nosocomial infection / 国际检验医学杂志

ABSTRACT

Objective To investigate the characteristics of nosocomial infection of carbapenem resistant En-terobacteriaceae ,then to study the risk factors and prognosis of patients ,as to provide evidence for effective control of CRE hospital infection .Methods A retrospective epidemiology study was conducted of CRE infec-ted patients from January 2016 to June 2017 .This was a 1∶2 matched case-control study of patients with in-fection due to carbapenem resistant Enterobacteriaceae and randomly select 218 patients with non CRE infec-tion in the same hospital as control group ,then the risk factors of CRE infection were investigate .Results A-mong the 109 cases CRE infection patients ,the most common bacteria were Klebsiella pneumoniae ,Enter-obacter cloacae and Escherichia coli .The CRE strains were more sensitive to minocycline than other common antibiotics ,the resistance rate to other antibiotics was more than 40% .Univariate analysis showed that ICU staying time more than 7 d ,using beta lactamase inhibitors and carbapenem antibiotics ,combination therapy and mechanical ventilation were the potential risk factors of CRE nosocomial infection .The non conditional multivariate Logistic regression analysis showed that Check in ICU more than 7 d (OR＝ 4 .981 ,95% CI 2 .451-10 .122 ) ,the use of containing beta lactamase inhibitor antibiotics (OR＝ 3 .718 ,95% CI 2 .162-6 .394) ,use of carbapenem antibiotics (OR＝3 .232 ,95% CI 1 .879-5 .561) ,and mechanical ventilation (OR＝5 .26 ,95% CI 2 .576-10 .742) were independent risk factors of CRE nosocomial infection .The nosocomial in- fection CRE strain was with highly antibiotic resistance rate ,and the average hospitalization time and mortality were significantly higher than those of the control group .Conclusion The carbapenem resistant Enterobacte-riaceae infection had multiple independent risk factors ,strengthening of these independent risk factor control can effectively prevent the spread of CRE isolates infection .