Risk Factors for the Acquisition of Carbapenemase-Producing Enterobacterales in the Intensive Care Unit of a University Hospital
10.14192/kjicp.2025.30.2.171
- Author:
Hae-Jin OH
1
;
Junghee KIM
;
Jihea CHOI
;
Eun Ju CHOO
Author Information
1. Department of Nursing, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- Publication Type:Original Article
- From:
Korean Journal of healthcare-associated Infection Control and Prevention
2025;30(2):171-180
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:This retrospective case-control study investigated the incidence and risk factors for carbapenemase-producing Enterobacterales (CPE) acquisition among patients admitted to the intensive care units (ICUs) of a university hospital in Korea.
Methods:Between January 1, 2021, and December 31, 2023, a total of 9,381 patients were admitted to the ICUs of a university hospital in Korea. Among these, 2,124 patients underwent at least two active surveillance cultures for carbapenem-resistant Enterobacterales (CRE).Newly acquired CPE colonization was identified in 38 patients, who were classified as the case group. For each case, two non-CRE controls were selected by matching for ICU type and exposure period, resulting in a control group of 76 patients. We analyzed the epidemiological, microbiological, patient-related, and environmental characteristics of patients who acquired CPE, and investigated risk factors associated with CPE acquisition.
Results:The proportion of patients who acquired CPE was 1.8%. Klebsiella pneumoniaewas the most frequently isolated species, accounting for 68.4% of cases, and blaKPC was the predominant genotype, identified in 89.5% of isolates. The median time from ICU admission to CPE acquisition was 14 days. In multivariable analysis, independent risk factors for CPE acquisition included prior carbapenem use (adjusted OR: 6.23, 95% CI 1.59-24.38), colonization with multidrug-resistant organisms (adjusted OR: 9.34, 95% CI 1.48-58.90), staying for more than three days in a bed within two meters of a hand hygiene faucet (adjusted OR: 7.94, 95% CI 1.45-43.44), and a higher ICU CRE incidence (adjusted OR: 1.60, 95% CI 1.11-2.30).
Conclusion:These findings highlight the importance of implementing targeted infection control measures and active surveillance to prevent CPE acquisition in ICU settings.
