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韩国一家三级护理中心耐碳青霉烯类大肠杆菌感染的危险因素：一项配对病例对照研究。

Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: a matched case-control study.

作者信息

Ahn Jin Young, Song Je Eun, Kim Min Hyung, Choi Heun, Kim Jae Kyung, Ann Hea Won, Kim Jung Ho, Jeon Yongduk, Jeong Su Jin, Kim Sun Bean, Ku Nam Su, Han Sang Hoon, Song Young Goo, Yong Dongeun, Lee Kyungwon, Kim June Myung, Choi Jun Yong

机构信息

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Am J Infect Control. 2014 Jun;42(6):621-5. doi: 10.1016/j.ajic.2014.02.024.

DOI:10.1016/j.ajic.2014.02.024

PMID:24837112

Abstract

BACKGROUND

Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE).

METHODS

We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea.

RESULTS

On univariate analysis, previous use of carbapenem (P < .01), fluoroquinolone (P < .01), and glycopeptide (P < .01), as well as length of hospital stay (P < .05), were significantly associated with CRE acquisition. On multivariate analysis, previous use of carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors.

CONCLUSIONS

At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE.

摘要

背景

革兰氏阴性杆菌对碳青霉烯类抗生素耐药是全球范围内新出现的威胁。本研究的目的是确定获得耐碳青霉烯类大肠杆菌（CRE）的危险因素。

方法

我们进行了一项配对病例对照研究，包括57例获得CRE的病例和114例对照（1:2配对），这些病例和对照选自2006年1月至2010年12月在韩国一家拥有2000张床位的三级医疗中心培养出对碳青霉烯类敏感大肠杆菌的患者。

结果

单因素分析显示，既往使用碳青霉烯类抗生素（P <.01）、氟喹诺酮类抗生素（P <.01）和糖肽类抗生素（P <.01）以及住院时间（P <.05）与获得CRE显著相关。多因素分析显示，既往使用碳青霉烯类抗生素（比值比[OR]，4.56；95%置信区间[CI] 1.44 - 14.46；P =.01）和既往使用氟喹诺酮类抗生素（OR，2.81；95% CI，1.14 - 6.99；P =.03）是独立的危险因素。