Risk factors for isolation of carbapenem-resistant Enterobacterales from normally sterile sites and urine.
Am J Infect Control
; 50(8): 929-933, 2022 08.
Article
in English
| MEDLINE | ID: covidwho-2000211
ABSTRACT
BACKGROUND:
Invasive infections caused by carbapenem-resistant Enterobacterales (CRE) are of significant concern in health care settings. We assessed risk factors for a positive CRE culture from a sterile site (invasive infection) compared to isolation from urine in a large patient cohort in Atlanta from August 2011 to December 2015.METHODS:
CRE cases required isolation, from urine or a normally-sterile site, of E. coli, Klebsiella spp., or Enterobacter spp. that were carbapenem-nonsusceptible (excluding ertapenem) and resistant to all third-generation cephalosporins tested. Risk factors were compared between patients with invasive and urinary infections using multivariable logistic regression.RESULTS:
A total of 576 patients had at least 1 incident case of CRE, with 91 (16%) having an invasive infection. In multivariable analysis, the presence of a central venous catheter (OR 3.58; 95% CI 2.06-6.23) or other indwelling device (OR 2.34; 95% CI 1.35-4.06), and recent surgery within the last year (OR 1.81; 95% CI 1.08-3.05) were associated with invasive infection when compared to urinary infection.DISCUSSION:
Health care exposures and devices were associated with invasive infections in patients with CRE, suggesting that targeting indwelling catheters, including preventing unwarranted insertion or encouraging rapid removal, may be a potential infection control intervention.CONCLUSIONS:
Future infection prevention efforts to decrease CRE cases in health care settings should focus on minimizing unnecessary devices.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Urinary Tract Infections
/
Enterobacteriaceae Infections
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Am J Infect Control
Year:
2022
Document Type:
Article
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