Factors associated with acquisition of carbapenem-resistant Enterobacteriaceae

Rev Lat Am Enfermagem. 2017 Oct 5:25:e2935. doi: 10.1590/1518-8345.1751.2935.
[Article in English, Portuguese, Spanish]

Abstract

Objective: to identify possible risk factors for acquisition of Enterobacterial strains with a marker for resistance to carbapenems.

Methods: exploratory case-control study performed in hospital settings. The study sample consisted of patients with biological specimens that tested positive for carbapenem-resistant Enterobacteriaceae (cases), with the disk diffusion test and Etest, and controls with biological samples testing negative for carbapenem-resistant Enterobacteriaceae. In all, 65 patients were included: 13 (20%) cases and 52 (80%) controls.

Results: the microorganisms isolated were Serratia marcescens (6), Klebsiella pneumoniae (4), and Enterobacter cloacae (3). Univariate analysis revealed that length of hospitalization prior to sample collection (p=0.002) and having a surgical procedure (p=0.006) were statistically significant. In the multivariable logistic regression model, both were still significant, with odds ratios of 0.93 (p = 0.009; 95% CI: 0.89 to 0.98) for length of hospitalization prior to sample collection, and 9.28 (p = 0.05; 95% CI: 1.01 to 85.14) for having a surgical procedure.

Conclusion: shorter hospitalization times and increased surveillance of patients undergoing surgery could play a decisive role in reducing the spread of carbapenem-resistant microorganisms in hospital settings.

MeSH terms

  • Aged
  • Carbapenem-Resistant Enterobacteriaceae*
  • Case-Control Studies
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors