Risk factors for KPC-producing Enterobacteriaceae acquisition and infection in a healthcare setting with possible local transmission: a case–control study

Cronin, Katie; Lorenzo, Yves S Poy; Olenski, Maxwell; Bloch, Aharon; Visvanathan, Kumar; Waters, Mary Jo; Buising, Kirsty

doi:10.1016/j.jhin.2017.02.010

Cited by 23 publications

(17 citation statements)

References 12 publications

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“…Prolonged hospital exposure and the use of antibiotics have been noted previously as risk factors for EPC acquisition. 10,11 Finally, in our study, low birth weight was significantly associated with CPE carriage in the newborn. This risk factor has not been described previously.…”

Section: Discussionsupporting

confidence: 57%

Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage

Mairi

Touati

Bessai

et al. 2019

American Journal of Infection Control

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The diffusion of carbapenemase-producing Enterobacteriaceae (CPE) represents a worldwide public health problem. This study revealed that the prevalence of OXA-48-producing enterobacteria was 4.6% (19/414) and 1.6% (7/422) in mothers and newborns, respectively, from 2 maternity units in Algeria. Previous hospital admission was an independent factor associated with an increased risk of CPE carriage in the mothers (P = .021). The low birth weight was significantly associated with this carriage in the newborns (P = .008). The screening of these bacteria is essential to prevent the dissemination of CPE.

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Section: Discussionsupporting

confidence: 57%

Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage

Mairi

Touati

Bessai

et al. 2019

American Journal of Infection Control

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“…In general, little information is available from LTCFs and the pediatric population; prevalence data on emerging pathogens such as CPE and VRE are scarce. AMR is primarily a concern in acute and intensive care patients due to severe underlying illnesses, antibiotic pre-treatment and medical interventions predisposing for hospital-acquired infections [54][55][56][57]. According to a nation-wide survey in Swiss healthcare facilities, 83% of institutions are currently performing targeted admission screenings for multidrug-resistant pathogens.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic-resistant pathogens in different patient settings and identification of surveillance gaps in Switzerland – a systematic review

et al. 2019

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The prevalence of antimicrobial resistance (AMR) varies significantly among different patient populations. We aimed to summarise AMR prevalence data from screening studies in different patient settings in Switzerland and to identify surveillance gaps. We performed a systematic review, searching Pubmed, MEDLINE, Embase (01/2000–05/2017) and conference proceedings for Swiss studies reporting on carbapenemase-producing Enterobacteriaceae (CPE), extended-spectrum beta-lactamases (ESBL), mobilised colistin-resistance, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) within different patient settings. We identified 2345 references and included 46 studies. For acute care patients, most screening data come from admission screenings, whereas AMR prevalence among hospitalised patients is largely unknown. Universal admission screenings showed ESBL-prevalences of 5–8% and MRSA-prevalences of 2–5%. For targeted screening, ESBL-prevalence ranged from 14–21%; MRSA-prevalence from 1–4%. For refugees, high ESBL (9–24%) and MRSA (16–24%) carriage rates were reported; returning travellers were frequently (68–80%) colonised with ESBL. Screening data for other pathogens, long-term care facility (LTCF) residents and pediatric populations were scarce. This review confirms high ESBL- and MRSA-carriage rates for risk populations in Switzerland. Emerging pathogens (CPE and VRE) and certain populations (inpatients, LTCF residents and children) are understudied. We encourage epidemiologists and public health authorities to consider these findings in the planning of future surveillance studies.

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“…Moreover, due to a high proportion of tetanus patients (>56%, 204/364) in this study, tetanus disease was likely to act as a confounding variable for the other risk factors. The other variables were selected based on literature review [ 20 – 28 ]. The continuous variable Charlson Comorbidity Index score was included as linear term.…”

Section: Methodsmentioning

confidence: 99%

Hospital-acquired colonization and infections in a Vietnamese intensive care unit

et al. 2018

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Data concerning intensive care unit (ICU)-acquired bacterial colonization and infections are scarce from low and middle-income countries (LMICs). ICU patients in these settings are at high risk of becoming colonized and infected with antimicrobial-resistant organisms (AROs). We conducted a prospective observational study at the Ho Chi Minh City Hospital for Tropical Diseases, Vietnam from November 2014 to January 2016 to assess the ICU-acquired colonization and infections, focusing on the five major pathogens in our setting: Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Klebsiella spp., Pseudomonas spp. and Acinetobacter spp., among adult patients with more than 48 hours of ICU stay. We found that 61.3% (223/364) of ICU patients became colonized with AROs: 44.2% (161/364) with rectal ESBL-producing E. coli and Klebsiella spp.; 30.8% (40/130) with endotracheal carbapenemase-producing Acinetobacter spp.; and 14.3% (52/364) with nasal methicillin-resistant S. aureus. The incidence rate of ICU patients becoming colonized with AROs was 9.8 (223/2,276) per 100 patient days. Significant risk factor for AROs colonization was the Charlson Comorbidity Index score. The proportion of ICU patients with HAIs was 23.4% (85/364), and the incidence rate of ICU patients contracting HAIs was 2.3 (85/3,701) per 100 patient days. The vascular catheterization (central venous, arterial and hemofiltration catheter) was significantly associated with hospital-acquired bloodstream infection. Of the 77 patients who developed ICU-acquired infections with one of the five specified bacteria, 44 (57.1%) had prior colonization with the same organism. Vietnamese ICU patients have a high colonization rate with AROs and a high risk of subsequent infections. Future research should focus on monitoring colonization and the development of preventive measures that may halt spread of AROs in ICU settings.

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Risk factors for KPC-producing Enterobacteriaceae acquisition and infection in a healthcare setting with possible local transmission: a case–control study

Cited by 23 publications

References 12 publications

Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage

Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage

Antibiotic-resistant pathogens in different patient settings and identification of surveillance gaps in Switzerland – a systematic review

Hospital-acquired colonization and infections in a Vietnamese intensive care unit

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