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학술저널
저자정보
강진숙 (인제대학교부속부산백병원) 이종윤 (부산대학교) 고미경 (부산대학교병원) 이순옥 (부산대학교) 이정은 (부산대학교 의과대학 내과) 김계형 (부산대학교)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.34 No.18
발행연도
2019.1
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1 - 11 (11page)

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Background: Infections caused by carbapenem-resistant Enterobacteriaceae (CRE) are associated with high mortality rates and their treatment is difficult because treatment is limited to certain antibiotics, such as colistin and tigecycline. We aimed to perform active surveillance culture of CRE (ASC-CRE) to monitor the prevalence of CRE acquisition during intensive care unit (ICU) care and to examine the potential risk factors associated with CRE acquisition. Methods: We conducted ASC-CRE on patients who were admitted to the ICU in the emergency room at a tertiary hospital. Rectal swabs were analyzed using methods established by the Centers for Disease Control and Prevention. To detect carbapenemase-producing CRE, a polymerase chain reaction assay to detect five carbapenemase genes (blaNDM, blaKPC, blaVIM, blaIMP-1, and blaOXA-48) was performed. Results: There were 22 CRE acquisition in 21 patients (2.6%, 21/810) and the incidence of CRE acquisition was 4.3/1,000 person-days, respectively. The most common species detected was Klebsiella pneumoniae (72.7%, 16/22), and 9 carbapenemase-producing CREs (7 blaKPC and 2 blaNDM) were detected. Independent risk factors associated with CRE acquisition were men gender (adjusted odds ratio [aOR], 5.3; 95% confidence interval [CI], 1.3–21.3), history of admission within one year (aOR, 3.9; 95% CI, 1.2–12.1), co-colonization with multidrug- resistant Acinetobacter baumannii (aOR, 15.6; 95% CI, 3.6–67.8) and extended-spectrum β-lactamases-producing bacteria (aOR, 4.7; 95% CI, 1.5–14.6), and exposure to glycopeptide antibiotics (aOR, 3.6; 95% CI, 1.3–9.9). Conclusion: The identification of patients with risk factors for CRE acquisition and early detection of CRE acquisition using ASC-CRE may be useful for CRE control.

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