1.Clinical Characteristics and Risk Factors of CarbapenemResistant Enterobacteriaceae: A Case-Control Study in a Tertiary Hospital in Malaysia
Ruzanna Dayanna Zawawi ; Ramliza Ramli ; Tg Mohd Ikhwan Tg Abu Bakar Sidik ; Isa Naina-Mohamed ; Leong Chee Loon
Malaysian Journal of Medicine and Health Sciences 2021;17(No.4):189-195
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) is increasingly reported worldwide causing serious
threats to healthcare. This study aimed to identify the common organisms associated with CRE, the clinical characteristics and risk factors for acquiring CRE infection and colonisation among hospitalised patients. Methods: This
is a matched, case-control study. Patients aged 18 years and above whom were hospitalised from January 2019 to
December 2019 and had CRE isolated from clinical specimens were matched with carbapenem-susceptible controls
(CSE), based on gender and age. Univariate and multivariate statistical analysis was performed. Results: Among 184
patients, Klebsiella pneumoniae was the most common organism causing CRE infection and colonisation. Chronic
kidney disease (p=0.025, OR:3.12, 95% CI:1.15-8.41), urinary catheterisation (p=0.005, OR:3.67, 95% CI:1.49-
9.00), prior use of cephalosporin (p<0.001, OR:4.69, 95% CI:1.96–11.22) and beta-lactam combination agent
(p<0.001, OR:7.18, 95% CI:2.98-17.26) were identified as the independent risk factors. Conclusion: Chronic kidney
disease, urinary catheterisation, prior use of cephalosporin and beta-lactam combination agents were independently
associated with CRE infection and colonisation. These findings enable targeting potential CRE cohorts, hence, necessitate early undertaking of prevention measures to delay the onset of CRE. A rigorous effort by antibiotic stewardship
an infection control team are pivotal.