Pathogenicity and risk factors for intestinal colonization of carbapenem-resistant Enterobacterales in patients from intensive care unit
10.12138/j.issn.1671-9638.20246111
- VernacularTitle:重症监护病房患者耐碳青霉烯类肠杆菌目细菌肠道定植的病原学及危险因素
- Author:
Jian-Shui YANG
1
;
Qi-Fen MIN
;
Xiao-Wen GONG
;
Zhi-Ping QI
;
Ye-Jun CAO
Author Information
1. 常州市肿瘤医院感染管理科,江苏常州 213032
- Keywords:
intensive care unit;
carbapenem-resistant Enterobacterales;
intestinal colonization;
risk factor
- From:
Chinese Journal of Infection Control
2024;23(11):1373-1378
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze risk factors and pathogenic characteristics of intestinal colonization of carbape-nem-resistant Enterobacterales(CRE)in patients from intensive care unit(ICU).Methods A total of 392 ICU pa-tients who underwent intestinal CRE screening in a tertiary hospital in Changzhou from March to December,2023 were divided into the colonization group(n=42)and the non-colonization group(n=350)according to the screening results.Clinical data of patients,including age,gender,underlying diseases,malignant tumors,radiotherapy,chemotherapy,infection before the last screening,antimicrobial use,and invasive procedures were collected for the analysis on risk factors and pathogenicity.Results Among 42 patients with positive CRE screening results,44 CRE strains were detected,mainly Klebsiella pneumoniae(65.91％),followed by Escherichia coli(15.91％)and En-terobacter cloacae(13.64％).The average time from admission in ICU to positive screening results of intestinal CRE in the colonization group was 14 days.Long term use of carbapenem antibiotics(OR=1.47,95％CI:1.31-1.65),mechanical ventilation(OR=1.14,95％CI:1.06-1.22),and Enterobacterales infection(OR=10.10,95％CI:3.28-32.09)were independent risk factors for intestinal CRE colonization.Patients who received carbap-enem antibiotics for ≥15 days(x2=167.52,P＜0.001)and those who received mechanical ventilation for ≥15 days(x2=101.03,P＜0.001)had higher risks for intestinal CRE colonization.Conclusion In clinical practice,it is necessary to improve pathogen detection,treat Enterobacterales infection timely,choose carbapenem antibiotics carefully,shorten treatment course,actively evaluate indications for mechanical ventilation,and wean off ventilator timely.
