BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) are important extremely drug-resistant pathogens that have emerged during the past decade. Early identification and isolation of carriers are key components of an effective infection control strategy in healthcare facilities. Very little is known about the natural history of CRE carriage. We aimed to determine the predictors of a positive CRE rectal screen test among patients with known CRE carriage screened at their next hospital encounter. METHODS: A case-control study was conducted. Sixty-six patients who tested positive for CRE carriage were surveyed for CRE rectal carriage at the next hospital encounter; screen-positive patients were compared with screen-negative control patients. Data were extracted from the patients' medical records and from the hospital computerized database. RESULTS: Twenty-three case patients and 43 control patients were identified. Predictors for a positive CRE rectal carriage test were (1) prior fluoroquinolone use (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.10-16.6), (2) admission from an institution or another hospital (OR, 4.04; 95% CI, 1.33-12.37), and (3) time interval less than or equal to 3 months since the first positive CRE test (OR, 3.59; 95% CI, 1.24-10.37). Among patients with no predictor variables, the likelihood of having a positive screen test at the next hospital encounter was 1/7. If they had at least 1 predictor, the likelihood increased to 1/2. CONCLUSIONS: Prior fluoroquinolone use, transfer from another healthcare facility, and admission less than or equal to 3 months since the first CRE isolation are predictors of persistent CRE rectal carriage. These predictors can be used in designing CRE prevention strategies.
BACKGROUND:Carbapenem-resistant Enterobacteriaceae (CRE) are important extremely drug-resistant pathogens that have emerged during the past decade. Early identification and isolation of carriers are key components of an effective infection control strategy in healthcare facilities. Very little is known about the natural history of CRE carriage. We aimed to determine the predictors of a positive CRE rectal screen test among patients with known CRE carriage screened at their next hospital encounter. METHODS: A case-control study was conducted. Sixty-six patients who tested positive for CRE carriage were surveyed for CRE rectal carriage at the next hospital encounter; screen-positive patients were compared with screen-negative control patients. Data were extracted from the patients' medical records and from the hospital computerized database. RESULTS: Twenty-three case patients and 43 control patients were identified. Predictors for a positive CRE rectal carriage test were (1) prior fluoroquinolone use (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.10-16.6), (2) admission from an institution or another hospital (OR, 4.04; 95% CI, 1.33-12.37), and (3) time interval less than or equal to 3 months since the first positive CRE test (OR, 3.59; 95% CI, 1.24-10.37). Among patients with no predictor variables, the likelihood of having a positive screen test at the next hospital encounter was 1/7. If they had at least 1 predictor, the likelihood increased to 1/2. CONCLUSIONS: Prior fluoroquinolone use, transfer from another healthcare facility, and admission less than or equal to 3 months since the first CRE isolation are predictors of persistent CRE rectal carriage. These predictors can be used in designing CRE prevention strategies.
Authors: M De Laveleye; T D Huang; P Bogaerts; C Berhin; C Bauraing; P Sacré; A Noel; Y Glupczynski Journal: Eur J Clin Microbiol Infect Dis Date: 2016-09-17 Impact factor: 3.267
Authors: Julia A Messina; Eric Cober; Sandra S Richter; Federico Perez; Robert A Salata; Robert C Kalayjian; Richard R Watkins; Nikole M Scalera; Yohei Doi; Keith S Kaye; Scott Evans; Robert A Bonomo; Vance G Fowler; David van Duin Journal: Infect Control Hosp Epidemiol Date: 2015-12-21 Impact factor: 3.254
Authors: Dror Marchaim; Teena Chopra; Ashish Bhargava; Christopher Bogan; Sorabh Dhar; Kayoko Hayakawa; Jason M Pogue; Suchitha Bheemreddy; Christopher Blunden; Maryann Shango; Jessie Swan; Paul R Lephart; Federico Perez; Robert A Bonomo; Keith S Kaye Journal: Infect Control Hosp Epidemiol Date: 2012-06-11 Impact factor: 3.254
Authors: A Lerner; E Solter; E Rachi; A Adler; H Rechnitzer; D Miron; L Krupnick; S Sela; E Aga; Y Ziv; A Peretz; K Labay; G Rahav; Y Geffen; K Hussein; O Eluk; Y Carmeli; M J Schwaber Journal: Eur J Clin Microbiol Infect Dis Date: 2015-11-18 Impact factor: 3.267
Authors: Moi Lin Ling; Yong Ming Tee; Soong Geck Tan; Ismawati M Amin; Kue Bien How; Kwee Yuen Tan; Lai Chee Lee Journal: Antimicrob Resist Infect Control Date: 2015-06-23 Impact factor: 4.887