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Article

Risk Factors for Carbapenemase-Producing Enterobacterales Infection or Colonization in a Korean Intensive Care Unit: A Case–Control Study

1
Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
2
Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
3
Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea
4
Department of Internal Medicine, National Health Insurance Service, Ilsan Hospital, Goyang 10444, Korea
5
Infection Control Unit, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
6
Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul 03722, Korea
7
Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Received: 15 August 2020 / Revised: 4 October 2020 / Accepted: 7 October 2020 / Published: 8 October 2020
(This article belongs to the Special Issue Antibiotics Use and Antimicrobial Resistance in Hospital)
The purpose of this study is to identify the factors related to the infection and/or colonization of carbapenemase-producing Enterobacterales (CPE) based on clinical and microbiological data for patients in the intensive care unit (ICU). All patients admitted to medical ICU were screened for CPE on admission and weekly, and this 1:2 case–control study included patients with CPE identified by screening or clinical cultures from 2017 to 2018. The clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). A total of 45 CPE patients were identified with a prevalence of 3.8%. The most frequent organism was Klebsiella pneumoniae (69%) and the carbapenemases belonged to the class A Klebsiella pneumoniae Carbapenemase (KPC-2) (87%), class B New Delhi Metallo-β-lactamase (NDM) (11%), and Imipenemase (IMP-1) (2%) strains. The PFGE profiles showed two large clustered groups of KPC-2-producing K. pneumoniae. In the multivariate analysis, pneumonia/chronic pulmonary disease, previous fluoroquinolone use, and previous use of nasogastric tube were the significant risk factors for CPE infection or colonization in ICU-admitted patients. Critical illness and underlying medical conditions such as pneumonia/chronic pulmonary disease, antimicrobial selective pressure, and the use of a medical device are identified as risk factors for CPE infection or colonization in ICU. Person to person transmission also contributed. View Full-Text
Keywords: carbapenemase-producing Enterobacterales; risk factor; active surveillance culture carbapenemase-producing Enterobacterales; risk factor; active surveillance culture
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MDPI and ACS Style

Kim, Y.A.; Lee, S.J.; Park, Y.S.; Lee, Y.J.; Yeon, J.H.; Seo, Y.H.; Lee, K. Risk Factors for Carbapenemase-Producing Enterobacterales Infection or Colonization in a Korean Intensive Care Unit: A Case–Control Study. Antibiotics 2020, 9, 680. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100680

AMA Style

Kim YA, Lee SJ, Park YS, Lee YJ, Yeon JH, Seo YH, Lee K. Risk Factors for Carbapenemase-Producing Enterobacterales Infection or Colonization in a Korean Intensive Care Unit: A Case–Control Study. Antibiotics. 2020; 9(10):680. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100680

Chicago/Turabian Style

Kim, Young A., Se J. Lee, Yoon S. Park, Yeo J. Lee, Jeong H. Yeon, Young H. Seo, and Kyungwon Lee. 2020. "Risk Factors for Carbapenemase-Producing Enterobacterales Infection or Colonization in a Korean Intensive Care Unit: A Case–Control Study" Antibiotics 9, no. 10: 680. https://0-doi-org.brum.beds.ac.uk/10.3390/antibiotics9100680

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