Colonization rates of carbapenem-resistant gram-negative bacteria among ICU patients and influencing factors:an active screening study
10.11816/cn.ni.2025-250919
- VernacularTitle:基于主动筛查的ICU患者肠道耐碳青霉烯类革兰阴性菌定植率及其影响因素
- Author:
Ying SHI
1
;
Bingwei ZHU
;
Jian GUO
;
Jiayi WANG
;
Qingfeng SHI
;
Jing WANG
;
Lifeng CHEN
Author Information
1. 同济大学附属东方医院院感科,上海 200120
- Publication Type:Journal Article
- Keywords:
Carbapenem-resistant gram-negative bacteria;
Carbapenems resistance gene;
Active screening;
Inten-sive care unit;
Colonization;
Influencing factor
- From:
Chinese Journal of Nosocomiology
2025;35(17):2571-2575
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the colonization rates of carbapenem-resistant gram-negative bacteria(CRGNB)in intestinal tracts of intensive care unit(ICU)patients and analyze the influencing factors.METHODS The ICU patients were recruited from a three-A general hospital of Shanghai from Jan.2024 to Dec.2024,an ac-tive screening was carried out for intestinal tract CRGNB,and the detection rates of 5 types of carbapenems resist-ance genes(CRGs)in the CRGNB strains were observed.The baseline data and hospitalization data before the ac-tive screening were collected from the patients,logistic regression analysis was performed for the influencing fac-tors for the colonization of CRGNB.The effects of targeted infection control measures on length of ICU stay,hos-pitalization cost and prognosis were observed and compared before and after the active screening was carried out.RESULTS A total of 748 patients were included in the active screening,and the colonization rate of CRGNB in intestinal tracts was 11.50％(86/748).Among the CRGs,the detection rate of blaNDM was the highest(6.82％),followed by blaIMP(4.55％)and blaKPC(2.54％).The result of logistic regression analysis showed that,with an increase of 1 each day of hospital stay before the admission to ICUs,the risk was increased by 1.055 times(OR=1.055,95％CI:1.030 to 1.081,P＜0.001),the risk was 0.442 times the use of as aminoglycosides as the use of β-lactams(OR=0.442,95％CI:0.244 to 0.801,P=0.007).The targeted infection control measures that were taken after the active screening shortened the length of hospital stay(Z=-3.514,P＜0.001),reduce the hospitalization cost(Z=3.030,P=0.002)and improve the prognosis of the patients(x2=7.470,P=0.006).CONCLUSIONS The colonization rates of CRGNB in intestinal tracts are high among the ICU patients.It is necessary to reduce the length of hospital stay prior to ICU and strengthen the surveillance of drug-resistant strains and management of antibiotics.
