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
. 2022 Jul 14;2(1):e118.
doi: 10.1017/ash.2022.244. eCollection 2022.

Case-case-control study of risk factors for carbapenem-resistant Enterobacterales infections among hospitalized patients

David M Stuever  1 , Amy K Ferketich  1 , Jiyoung Lee  2   3 , Kurt B Stevenson  4   3 , Thomas E Wittum  5   3
Affiliations

Case-case-control study of risk factors for carbapenem-resistant Enterobacterales infections among hospitalized patients

David M Stuever et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: To identify important risk factors for carbapenem-resistant Enterobacterales (CRE) infections among hospitalized patients.

Design: We utilized a case-case-control design that compared patients with CRE infections to patients with carbapenem-susceptible Enterobacterales (CSE) infections and randomly selected controls during the period from January 2011 through December 2016.

Setting: The study population was selected from patients at a large metropolitan tertiary-care and instructional medical center.

Patients: Cases of CRE were defined as initial admission of adults diagnosed with a bacterial infection of an Enterobacterales species resistant clinically or through sensitivity testing to carbapenems 48 hours or more after admission. Cases of CSE were selected from the same patient population as the CRE cases within a 30-day window for admission, with diagnostic pathogens identified as susceptible to carbapenems. Controls were defined as adult patients admitted to any service within a 30-day window from a CRE case for >48 hours who did not meet either of the above case definitions during that admission.

Results: Antibiotic exposure within 90 days prior to admission and length of hospital stay were both associated with increased odds of CRE and CSE infections compared to controls. Patients with CRE infections had >18 times greater odds of prior antibiotic exposure compared to patients with CSE infections.

Conclusions: Antibiotic exposure and increased length of hospital stay may result in increased patient risk of developing an infection resistant to carbapenems and other β-lactams.

PubMed Disclaimer

References

    1. Drug resistance biggest threats. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugresistance/biggest-threats.html. Published 2019. Accessed December 16, 2019.
    1. The Obama White House Administration. National action plan for combating antibiotic-resistant bacteria, 2015. The White House website. https://obamawhitehouse.archives.gov/sites/default/files/docs/national_a.... Published 2015. Accessed December 1, 2019.
    1. Temkin E, Adler A, Lerner A, Carmeli Y. Carbapenem-resistant Enterobacteriaceae: biology, epidemiology, and management. Ann N Y Acad Sci 2014;1323:22–42. - PubMed
    1. Leavitt A, Navon-Venezia S, Chmelnitsky I, Schwaber MJ, Carmeli Y. Emergence of KPC-2 and KPC-3 in carbapenem-resistant Klebsiella pneumoniae strains in an Israeli hospital. Antimicrob Agents Chemother 2007;51:3026–3029. - PMC - PubMed
    1. Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clin Infect Dis 2011;53:60–67. - PubMed

LinkOut - more resources