Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan
Prevalence of, and risk factors for, carriage of carbapenem-resistant Enterobacteriaceae among hospitalized patients in Japan
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DOI：
10.1016/j.jhin.2017.07.015
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发表时间：
2017-11-01
影响因子：
6.9
通讯作者：
Tomono, K.
中科院分区：
文献类型：
--
作者：
Yamamoto, N.;Asada, R.;Tomono, K.
背景：据报道，日本碳青霉烯类耐药肠杆菌科（CRE）的患病率低于许多其他国家。然而，在日本尚未对CRE携带进行广泛的监测。目的：使用改良的选择性培养基，调查日本被认为是CRE携带者高风险的康复期患者中CRE携带的患病率。方法：在22家急性护理医院（ACH）和21家长期护理医院（LTCH）进行了横断面调查2015年12月至2016年1月在北方大坂举行。使用失禁辅助器、肠内营养管或导尿管的患者入组。使用新开发的M-ECC检查粪便标本中的产亚胺培南酶（IMP）CRE，这是日本最常见的CRE形式。阳性分离株进行聚合酶链反应和测序分析。结果：在1507例患者中，184例（12.2%）携带CRE。LTCHs的阳性率（14.9%）明显高于ACHs（3.6%）（P
Background: The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been reported to be lower in Japan than in many other countries. However, extensive surveillance for CRE carriage has not been performed in Japan.Aim: To investigate the prevalence of CRE carriage in Japan among convalescent patients considered to be at high risk of being CRE carriers using an improved selective culture medium.Methods: A cross-sectional survey was conducted in 22 acute care hospitals (ACHs) and 21 long-term care hospitals (LTCHs) in northern Osaka from December 2015 to January 2016. Patients who used incontinence aids, an enteral feeding tube or a urinary catheter were enrolled. Faecal specimens were examined using the newly developed M-ECC for imipenemase (IMP)-producing CRE, which is the most prevalent form of CRE in Japan. The positive isolates were analysed by polymerase chain reaction and sequencing. Risk factors associated with carriage were analysed by logistic regression.Findings: Among 1507 patients, 184 (12.2%) carried CRE. The percentage of positive patients was significantly higher in LTCHs (14.9%) than in ACHs (3.6%) (P