Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug 30;10(1):128.
doi: 10.1186/s13756-021-00994-9.

Admission screening and cohort care decrease carbapenem resistant enterobacteriaceae in Vietnamese pediatric ICU's

K Garpvall  1 , V Duong  2 , S Linnros  1 , T N Quốc  2 , D Mucchiano #  1 , S Modeen #  1 , L Lagercrantz #  1 , A Edman #  1 , N K Le  2   3   4 , T Huong  2 , N T B Hoang  2 , H T Le  2 , D Tk Khu  2   3 , D M Tran  2   4 , P H Phuc  2   3   4 , H Hanberger  3   5 , L Olson  6   7   8 , M Larsson  1   3
Affiliations

Admission screening and cohort care decrease carbapenem resistant enterobacteriaceae in Vietnamese pediatric ICU's

K Garpvall et al. Antimicrob Resist Infect Control. .

Abstract

Objectives: To assess if admission screening for Carbapenem Resistant Enterobacteriaceae (CRE) and cohort care can reduce CRE acquisition (CRE colonization during hospital stay), Hospital Acquired Infections (HAI), hospital-stay, mortality, and costs in three Intensive Care Units (ICU's) at the Vietnamese National Children's Hospital.

Method: CRE screening using rectal swabs and ChromIDCarbas elective culture at admission and if CRE negative, once weekly. Patients were treated in cohorts based on CRE colonization status.

Results: CRE colonization at baseline point-prevalence screening was 76.9% (103/134). Of 941 CRE screened at admission, 337 (35.8%) were CREpos. 694 patients met inclusion criteria. The 244 patients CRE negative at admission and screened > 2 times were stratified in 8 similar size groups (periods), based on time of admission. CRE acquisition decreased significant (OR - 3.2, p < 0.005) from 90% in period 2 (highest) to 48% in period 8 (last period). Patients with CRE acquisition compared to no CRE acquisition had a significantly higher rate of culture confirmed HAI, n = 20 (14%) vs. n = 2 (2%), longer hospital stays, 3.26 vs. 2.37 weeks, and higher total treatment costs, 2852 vs. 2295 USD.

Conclusion: Admission CRE screening and cohort care in pediatric ICU's significantly decreased CRE acquisition, cases of HAI and duration of hospital-stay.

Keywords: Admission screening; Carbapenem resistant Enterobacteriaceae; Cohort care; Hospital acquired infections; Pediatric and neonatal care.

PubMed Disclaimer

Conflict of interest statement

There is no reported conflict of interest. All authors have agreed to participate in the paper.

Figures

Fig. 1
Fig. 1
CRE screening and cohort care intervention flowchart
Fig. 2
Fig. 2
Flowchart for patient recruitment
Fig. 3
Fig. 3
Change per period in CRE acquisition rate, culture confirmed HAI, healthcare costs in USD (0.1 = 1000 USD) and average duration of hospital stay (0.1 = 1 week): per period and linear trend (dashed strait line) and standard error for each variable and period (vertical bar)
See this image and copyright information in PMC

References

    1. World Health Organization. Antimicrobial resistance: global report on surveillance2014. 1 online resource (xxii, 232 pages) p.
    1. Kiratisin P, Chongthaleong A, Tan TY, Lagamayo E, Roberts S, Garcia J, et al. Comparative in vitro activity of carbapenems against major Gram-negative pathogens: results of Asia-Pacific surveillance from the COMPACT II study. Int J Antimicrob Agents. 2012;39(4):311–316. doi: 10.1016/j.ijantimicag.2012.01.002. - DOI - PubMed
    1. Nordmann P, Dortet L, Poirel L. Carbapenem resistance in Enterobacteriaceae: here is the storm! Trends Mol Med. 2012;18(5):263–272. doi: 10.1016/j.molmed.2012.03.003. - DOI - PubMed
    1. El-Gamal MI, Brahim I, Hisham N, Aladdin R, Mohammed H, Bahaaeldin A. Recent updates of carbapenem antibiotics. Eur J Med Chem. 2017;5(131):185–195. doi: 10.1016/j.ejmech.2017.03.022. - DOI - PubMed
    1. Martin A, Fahrbach K, Zhao Q, Lodise T. Association between Carbapenem resistance and mortality among adult, hospitalized patients with serious infections due to enterobacteriaceae: results of a systematic literature review and meta-analysis. 2018 (2328–8957 (Print)). eng. - PMC - PubMed

Publication types