Peking University People's Hospital. Beijing. China.
Beijing Hospital, Beijing. China.
J Glob Antimicrob Resist. 2022 Sep;30:191-198. doi: 10.1016/j.jgar.2022.04.005. Epub 2022 Apr 13.
This study aims to explore the high-risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infection of hospitalised patients in high-risk departments.
This study is a multicentre, retrospective study. CRE screening positive patients from 1 January 2016 to 31 December 2018 of high-risk departments in five tertiary first-class teaching hospitals in Beijing collect the patients' CRE test specimen information, CRE infection information and outcomes. The patients were divided into a colonisation group and an infection group for comparative analysis. A logistic regression model was established to explore the risk factors of CRE infection. Subgroup analysis was conducted according to invasive procedures and the type of the infection.
In total, 344 patients were included in this study, including 85 (24.71%) colonisation and 259 (75.29%) infection; 36.09% CRE colonisation converted to infection, and the mean conversion time from colonisation to infection was 6.5 (4.0, 18.8) days. Renal disease, granulocytosis, invasive procedures and the time from hospital stay to positive CRE were the risk factors for CRE infection. The subgroup analysis showed that the rate of CRE infection in the invasive group was higher than in the non-invasive group (P < 0.001), and the rate of exacerbation or death in the invasive group was also higher than in the non-invasive group (P = 0.019). The average length of ICU and hospitalisation in the healthcare-associated infection group were significantly higher than those in the community infection group, but there was no difference in the proportion of final exacerbation or death between them (P = 0.727).
Kidney disease, granulocytosis, invasive procedures and CRE detection time are the risk factors for CRE infection. Carrying out CRE screening in patients as early as possible and taking effective intervention measures in time to avoid adverse consequences is all important.
本研究旨在探讨高危科室住院患者发生耐碳青霉烯肠杆菌科（CRE）感染的高危因素。
本研究为多中心、回顾性研究。收集 2016 年 1 月 1 日至 2018 年 12 月 31 日北京五所三级甲等教学医院高危科室 CRE 筛查阳性患者的 CRE 检测标本信息、CRE 感染信息和结局。根据患者是否为定植和感染将患者分为定植组和感染组进行对比分析。采用 logistic 回归模型探讨 CRE 感染的危险因素。根据有创操作和感染类型进行亚组分析。
共纳入 344 例患者，其中定植 85 例（24.71%），感染 259 例（75.29%）；CRE 定植向感染转化的比例为 36.09%，从定植到感染的平均转化时间为 6.5（4.0，18.8）天。肾脏病、粒性白细胞增多症、有创操作和住院至 CRE 阳性时间是 CRE 感染的危险因素。亚组分析显示，有创组 CRE 感染率高于非有创组（P<0.001），有创组恶化或死亡比例也高于非有创组（P=0.019）。医院获得性感染组 ICU 及住院时间均明显长于社区感染组，但两组最终恶化或死亡比例无差异（P=0.727）。
肾脏病、粒性白细胞增多症、有创操作和 CRE 检测时间是 CRE 感染的危险因素。尽早对患者进行 CRE 筛查，并及时采取有效的干预措施，避免不良后果的发生至关重要。
