Epidemiological study on intestinal active surveillance of carbapenem-resistant Enterobacteriaceae in neurology intensive care unit

doi:10.3877/cma.j.issn.2095-5820.2023.04.007

Abstract

Abstract:

Objective

To investigate the intestinal colonization and infection characteristics of carbapenem-resistant Enterobacteriaceae (CRE) of active surveillance in neurology intensive care unit (NICU) patients and then provide risk factors for intestinal colonization and nosocomial infection.

Methods

A retrospective case-control study was based on the relevant statistic data on NICU patients in The First Affiliated Hospital, Sun Yet-Sen University from 1st January 2020 to 31st December 2022.

Results

The positive rate of intestinal CRE active surveillance in NICU patients was 32.34% (54/167), and the admission rate was 2.40% (4/167) and the hospital acquired rate was 29.94% (50/167). Of the 54 CRE, 90.74% (49/54) were Klebsiell a pneumoniae producing Class A serine KPC carbapenemase. Among the 167 patients, the proportion of CRE infection was 16.77% (28/167). Intestinal CRE colonization was an independent risk factor for CRE infection in NICU patients.

Conclusions

The positive rate of active screening for intestinal CRE in NICU wards is high. The longer the patients stay in the ICU, the higher risk of CRE detection. Positive intestinal surveillance of CRE is an independent risk factor for nosocomial infection, and early detection of CRE through active surveillance and infection control measures can help reduce the risk of nosocomial transmission.

Key words: neurology intensive care unit, carbapenem-resistant Enterobacteriaceae, intestinal active surveillance

Pingjuan Liu, Kecheng Luo, Jiayin Wu, Kang Liao, Wenwen Hu, Yili Chen. Epidemiological study on intestinal active surveillance of carbapenem-resistant Enterobacteriaceae in neurology intensive care unit[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2023, 11(04): 235-240.

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一般资料	筛查阳性/例	筛查阴性/例	χ²值	P值
性别
男	32	76	1.36	0.244
女	22	37	1.36	0.244
年龄/岁
≥65	21	36	2.781	0.095
<65	33	77	2.781	0.095

一般资料	筛查阳性/例	筛查阴性/例	χ²值	P值
性别
男	32	76	1.36	0.244
女	22	37	1.36	0.244
年龄/岁
≥65	21	36	2.781	0.095
<65	33	77	2.781	0.095

抗生素使用	CRE筛查阳性（n=54）/例（%）	CRE筛查阴性（n=113）/例（%）	单因素分析	多因素分析
抗生素使用	CRE筛查阳性（n=54）/例（%）	CRE筛查阴性（n=113）/例（%）	P值	OR值	P值
β-内酰胺酶抑制剂复合制剂	31（57.41）	64（56.64）	0.492
碳青霉烯类	28（51.85）	26（23.01）	0.003	3.887	0.018
抗真菌药	16（29.63）	9（7.96）	0.003	4.694	0.018
氟喹诺酮类	8（14.81）	8（7.08）	0.060	4.645	0.023
头孢类	5（9.26）	19（16.81）	0.397
替加环素	1（1.85）	4（3.54）	1.000

抗生素使用	CRE筛查阳性（n=54）/例（%）	CRE筛查阴性（n=113）/例（%）	单因素分析	多因素分析
抗生素使用	CRE筛查阳性（n=54）/例（%）	CRE筛查阴性（n=113）/例（%）	P值	OR值	P值
β-内酰胺酶抑制剂复合制剂	31（57.41）	64（56.64）	0.492
碳青霉烯类	28（51.85）	26（23.01）	0.003	3.887	0.018
抗真菌药	16（29.63）	9（7.96）	0.003	4.694	0.018
氟喹诺酮类	8（14.81）	8（7.08）	0.060	4.645	0.023
头孢类	5（9.26）	19（16.81）	0.397
替加环素	1（1.85）	4（3.54）	1.000

项目	院内感染（n=28）/例（%）	非院内感染（n=139）/例（%）	单因素分析	多因素分析
项目	院内感染（n=28）/例（%）	非院内感染（n=139）/例（%）	P值	OR值	P值
一般资料
男	15（53.57）	93（66.91）	0.178
年龄≥65岁	9（32.14）	45（32.37）	0.173	0.759	0.776
侵入性操作
气管插管	11（39.29）	58（41.73）	0.796
气管切开	13（46.43）	42（30.22）	0.023	2.965	0.197
胃管	19（67.86）	73（52.52）	0.138
尿管	20（71.43）	69（49.64）	0.352
主要诊断
脑梗死	13（46.43）	49（35.25）	0.521
脑动脉狭窄	5（17.86）	5（3.60）	0.135	4.547	0.284
脑出血	7（25.00）	33（23.74）	0.887
缺血缺氧性脑病	3（10.71）	8（5.76）	0.397
脑积水	3（10.71）	8（5.76）	0.397
肺栓塞	2（7.14）	7（5.04）	0.528
冠状动脉粥样硬化性心脏病	3（10.71）	13（9.35）	0.734
肿瘤	5（17.86）	18（12.95）	0.547
高血压	15（53.57）	64（46.04）	0.799
糖尿病	9（32.14）	40（28.78）	0.950
血脂异常	3（10.71）	6（4.32）	0.450
CRE筛查阳性	25（89.29）	29（20.86）	<0.001	19.419	0.001

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