Alshubaily Ali M, Alosaimi Aeshah S, Alhothli Bushra I, Althawadi Sahar I, Alghamdi Salem M
Pediatric Infectious Diseases Section, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Infection Control and Hospital Epidemiology, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Infect Control Hosp Epidemiol. 2024 Oct 14:1-5. doi: 10.1017/ice.2024.156.
In this study, we aim to estimate the risk of developing clinical multidrug-resistant organism (MDRO) infection with carbapenem-resistant (CRE), methicillin-resistant (MRSA), or vancomycin-resistant enterococci (VRE) in colonized patients compared with non-colonized admitted to high-risk areas with a main focus on CRE colonization/infection.
Retrospective cohort study conducted at a tertiary care facility.
This study included patients enrolled in active surveillance testing (AST) for CRE, MRSA, or VRE during the year 2021. Development of relevant invasive infection within 365 days of the AST result was collected as the primary outcome. The association between MDRO colonization and infection was calculated using the risk ratio. The prevalence of CRE organisms and carbapenemase genes is presented.
A total of 19,134 ASTs were included in the analysis (4,919 CRE AST, 8,303 MRSA AST, and 5,912 VRE AST). Patient demographics were similar between colonized and non-colonized groups. Colonization was associated with an increased risk of infection in the 3 cohorts (CRE, MRSA, and VRE), with risk ratios reported as 4.6, 8.2, and 22, respectively. Most patients (88%) develop CRE infection with the same colonizing carbapenemase gene. Oxa-48/NDM was the most common organism detected in CRE infection.
The study demonstrated that colonization with CRE, MRSA, or VRE is a risk factor for developing infections caused by the respective bacteria. The high percentage of match between carbapenemase genes detected in colonization and infection indicates that screening results might be used to inform infection management and treatment.
在本研究中，我们旨在评估与未定植的高危区域住院患者相比，定植碳青霉烯类耐药肠杆菌科细菌（CRE）、耐甲氧西林金黄色葡萄球菌（MRSA）或耐万古霉素肠球菌（VRE）的患者发生临床多重耐药菌（MDRO）感染的风险，主要关注CRE定植/感染情况。
在一家三级医疗保健机构进行的回顾性队列研究。
本研究纳入了2021年期间参与CRE、MRSA或VRE主动监测检测（AST）的患者。收集AST结果后365天内相关侵袭性感染的发生情况作为主要结局。使用风险比计算MDRO定植与感染之间的关联。列出了CRE菌株和碳青霉烯酶基因的流行情况。
分析共纳入19134次AST（4919次CRE AST、8303次MRSA AST和5912次VRE AST）。定植组和未定植组的患者人口统计学特征相似。在3个队列（CRE、MRSA和VRE）中，定植均与感染风险增加相关，风险比分别为4.6、8.2和22。大多数患者（88%）发生的CRE感染具有相同的定植碳青霉烯酶基因。Oxa-48/NDM是CRE感染中最常见的检测到的菌株。
该研究表明，CRE、MRSA或VRE定植是由相应细菌引起感染的危险因素。定植和感染中检测到的碳青霉烯酶基因之间的高匹配百分比表明，筛查结果可能有助于指导感染管理和治疗。
