单位：[1]Department of Laboratory Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.华中科技大学同济医学院附属同济医院检验科[2]The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.[3]Department of Emergency Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.华中科技大学同济医学院附属同济医院急诊医学科[4]Department of Haematology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China华中科技大学同济医学院附属同济医院[5]Department of Nursing,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.华中科技大学同济医学院附属同济医院护理部[6]Department of Nosocomial Infection Management,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China华中科技大学同济医学院附属同济医院感染科党政职能科室医院感染管理科[7]Department of Pharmacy,Tongji Hospital,TongjiMedical College,Huazhong University of Science and Technology,Wuhan,China.华中科技大学同济医学院附属同济医院药学部
Background Searching the risk factors for carbapenem-resistant Enterobacteriaceae (CRE) infection is important in clinical practice. In the present study, we aim to investigate bacterial characteristics of colonizing strains and their correlation with subsequent CRE infection. Methods Between May 2018 and January 2019, patients hospitalized in the department of haematology and intensive care unit (ICU) were screened for CRE by rectal swabs and monitored for the outcome of infection. We identified the species and carbapenemase-encoding genes of colonizing strains and performed antimicrobial susceptibility tests and multilocus sequence typing (MLST). Risk factors for subsequent CRE infections were ascertained by univariate and multivariable analysis. Results We collected a total of 219 colonizing strains from 153 patients. Klebsiella pneumoniae was the most abundant species, and MLST analysis showed rich diversity. K. pneumoniae carbapenemase (KPC) was predominant in the infection group (72.4%). In the non-infection group, 35.4% of strains were non-carbapenemase-producing CRE (NCP-CRE), and New Delhi metallo-beta-lactamase (NDM) was predominant (42.2%). The rate of high-level carbapenem resistance (minimum inhibitory concentration [MIC] >= 64 mg/L for meropenem and ertapenem, >= 32 mg/L for imipenem) was remarkably higher in the infection group than in the non-infection group (P < 0.001). Univariate analysis showed that K. pneumoniae, high-level carbapenem resistance, CP-CRE and KPC-CRE were infection risk factors after CRE colonization. On multivariable analysis with different carbapenemase dichotomizations, KPC-CRE (adjusted odds ratio [aOR], 4.507; 95% confidence interval [CI], 1.339-15.171; P = 0.015) or imipenem MIC >= 32 mg/L (aOR, 9.515; 95% CI, 1.617-55.977; P = 0.013) were respectively identified as independent risk factors for subsequent infection. Conclusions Patients colonized with KPC-CRE or strains with an imipenem MIC >= 32 mg/L were at particularly high risk of subsequent CRE infections during their hospital stay.
基金：
National Mega Project on Major Infectious Disease Prevention [2017ZX10103005-007]; Natural Science Foundation of HubeiNatural Science Foundation of Hubei Province [2019CFB666]
第一作者单位：[1]Department of Laboratory Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,China.
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推荐引用方式(GB/T 7714)：
lin qun,wang yue,yu jing,et al.Bacterial characteristics of carbapenem-resistant Enterobacteriaceae (CRE) colonized strains and their correlation with subsequent infection[J].BMC INFECTIOUS DISEASES.2021,21(1):doi:10.1186/s12879-021-06315-0.
APA：
lin,qun,wang,yue,yu,jing,li,shusheng,zhang,yicheng...&sun,ziyong.(2021).Bacterial characteristics of carbapenem-resistant Enterobacteriaceae (CRE) colonized strains and their correlation with subsequent infection.BMC INFECTIOUS DISEASES,21,(1)
MLA：
lin,qun,et al."Bacterial characteristics of carbapenem-resistant Enterobacteriaceae (CRE) colonized strains and their correlation with subsequent infection".BMC INFECTIOUS DISEASES 21..1(2021)
