Epidemiology and risk factors for carbapenem-resistant Enterobacteriaceae colonisation and infections: case-controlled study from an academic medical center in a southern area of China
Epidemiology and risk factors for carbapenem-resistant Enterobacteriaceae colonisation and infections: case-controlled study from an academic medical center in a southern area of China
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耐碳青霉烯类肠杆菌定植和感染的流行病学和危险因素：中国南方地区学术医疗中心的病例对照研究
DOI：
10.1093/femspd/ftz034
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发表时间：
2019-06-01
影响因子：
3.3
通讯作者：
Liang, Xianming
中科院分区：
文献类型：
--
作者：
Fang, Lili;Lu, Xiaohui;Liang, Xianming
目的：虽然耐碳青霉烯类肠杆菌科细菌（CRE）及相关感染的出现和传播对全球公共卫生构成严重威胁，但其流行病学和相关风险因素仍然知之甚少，并且因地理位置而异。方法：在一项病例对照回顾性研究中，我们检查了 2015 年 1 月至 2017 年 1 月 CRE 定植和感染的患病率、患者背景和危险因素，以及所有患者来源的 CRE。在研究期间，从 2875 名入组患者中随机选择分离的碳青霉烯类敏感肠杆菌科细菌 (CSE)。结果：CRE 定植率和感染检出率为 47/2875 (1.6%)。呼吸道标本最常见于 20/47 (42.6%) 病例。肺炎克雷伯菌是 35/47 (74.5%) CRE 中的主要分离株。至于碳青霉烯酶，最常在 38/47 (80.9%) 肠杆菌科细菌中检测到产生 KPC-2 的细菌。 CRE组和CSE组之间无基础疾病（P = 0.004）、肺部疾病（P = 0.018）和培养前30天内未使用抗生素（P < 0.001）具有统计学意义。结论：肺炎克雷伯菌是CRE的主要分离株。 blaKPC-2 是主要的 CRE 基因。基础疾病，尤其是肺部疾病和培养前 30 天内使用的抗生素是获得 CRE 的关键风险因素。
OBJECTIVE: While the emergence and spread of carbapenem-resistant Enterobacteriaceae (CRE) and related infections pose serious threats to global public health, the epidemiology and associated risk factors remain poorly understood and vary by geography. METHODS: In a case-controlled retrospective study, we examined the prevalence, patient background and risk factors for CRE colonisation and infections, and all patient-derived CRE from January 2015 to January 2017. Isolated carbapenem-susceptible Enterobacteriaceae (CSE) from 2875 enrolled patients were randomly selected during the study. RESULTS: CRE colonisation and infections detection rates were 47/2875 (1.6%). Respiratory tract specimens were most frequently seen in 20/47 (42.6%) cases. Klebsiella pneumoniae was the main isolate in 35/47 (74.5%) CRE. As for carbapenemase, KPC-2-producing bacteria was most frequently detected in 38/47 (80.9%) Enterobacteriaceae. No underlying conditions (P = 0.004), pulmonary diseases (P = 0.018) and no antibiotics used prior to culture within 30 days (P < 0.001) were statistically significant between the CRE and CSE groups. CONCLUSION: Klebsiella pneumoniae was the main isolate of CRE. The blaKPC-2 was the predominant CRE gene. Underlying conditions especially pulmonary diseases and antibiotics used prior to culture within 30 days represented key risk factors for acquisition of CRE.