Lijun Yin1, Leiyan He2, Jin Miao1, Weiqing Yang1, Xiaohua Wang1, Jian Ma1, Nana Wu1, Yun Cao3, Laishuan Wang4, Guoping Lu5, Liling Li6, Chunmei Lu4, Jing Hu5, Lei Zhang2, Bing Zhao7, Xiaowen Zhai8, Chuanqing Wang9. 1. Department of Nosocomial Infection Control, Children's Hospital of Fudan University, Shanghai, China. 2. The Clinical Microbiology Laboratory, Children's Hospital of Fudan University, Shanghai, China. 3. Department of neonatal intensive care unit, Children's Hospital of Fudan University, Shanghai, China. 4. Department of Neonatal room, Children's Hospital of Fudan University, Shanghai, China. 5. Department of Pediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China. 6. Department of Nursing Department, Children's Hospital of Fudan University, Shanghai, China. 7. Shanghai Pudong Center for Disease Control and Prevention, Shanghai, China. 8. Department of Hematology, Children's Hospital of Fudan University, Shanghai, China. Electronic address: zhaixiaowendy@163.com. 9. Department of Nosocomial Infection Control and the Clinical Microbiology Laboratory, Children's Hospital of Fudan University, Shanghai, China. Electronic address: chuanqing523@163.com.
Abstract
BACKGROUND: With the increasing use of carbapenems in clinic practice, carbapenem-resistant Enterobacteriaceae (CRE) has also increased, thus posing a significant threat to human health. AIM: To assess the effects of CRE colonization active screening and various CRE patient placements implemented in decreasing CRE infection risk. METHODS: CRE colonization screening and various CRE patient placements were performed across CRE high-risk departments (PICU, NICU, neonatal wards and hematology departments) between 2017 and 2018, respectively. FINDING: In 2018, more than 80% neonatal CRE positive patients were isolated using single room or same room isolation, and more than 50% non-neonatal patients were, with no cohort placement. The CRE nosocomial infection incidences decreased from 1.96% to 0.63% in NICU, and from 0.57% to 0.30% in neonatal wards (all P<0.05) while no significant changes were found in the other departments. The CRE colonization incidence at different length hospital stay (LOS) decreased at 8-14days and >14days LOS in CRE high-risk departments (all P<0.05). In addition, 62.5% clinical strains, 66.7% screening strains, and 74.1% nosocomial infection strains were belonged to CC17 complex group in neonatal isolates; while, 56.6%, 47.5% and 100% strains mentioned above were belonged to CC11 complex group in non-neonatal isolates respectively. The predominant carbapenemase gene was blaNDM-1 (98%) in neonatal and blaKPC-2 (70%) in non-neonatal CR-KP stains. CONCLUSIONS: Active CRE colonization surveillance and CRE positive patient propriety placement may decrease the CRE infection risk. Neonatal and non-neonatal CR-KP isolates showed different CRE molecular characteristics, which could further benefit CRE infection precaution and antibiotic therapy.
BACKGROUND: With the increasing use of carbapenems in clinic practice, carbapenem-resistant Enterobacteriaceae (CRE) has also increased, thus posing a significant threat to human health. AIM: To assess the effects of CRE colonization active screening and various CRE patient placements implemented in decreasing CRE infection risk. METHODS: CRE colonization screening and various CRE patient placements were performed across CRE high-risk departments (PICU, NICU, neonatal wards and hematology departments) between 2017 and 2018, respectively. FINDING: In 2018, more than 80% neonatal CRE positive patients were isolated using single room or same room isolation, and more than 50% non-neonatal patients were, with no cohort placement. The CRE nosocomial infection incidences decreased from 1.96% to 0.63% in NICU, and from 0.57% to 0.30% in neonatal wards (all P<0.05) while no significant changes were found in the other departments. The CRE colonization incidence at different length hospital stay (LOS) decreased at 8-14days and >14days LOS in CRE high-risk departments (all P<0.05). In addition, 62.5% clinical strains, 66.7% screening strains, and 74.1% nosocomial infection strains were belonged to CC17 complex group in neonatal isolates; while, 56.6%, 47.5% and 100% strains mentioned above were belonged to CC11 complex group in non-neonatal isolates respectively. The predominant carbapenemase gene was blaNDM-1 (98%) in neonatal and blaKPC-2 (70%) in non-neonatal CR-KP stains. CONCLUSIONS: Active CRE colonization surveillance and CRE positive patient propriety placement may decrease the CRE infection risk. Neonatal and non-neonatal CR-KP isolates showed different CRE molecular characteristics, which could further benefit CRE infection precaution and antibiotic therapy.
Authors: Marilena Agosta; Daniela Bencardino; Marta Argentieri; Laura Pansani; Annamaria Sisto; Marta Luisa Ciofi Degli Atti; Carmen D'Amore; Lorenza Putignani; Pietro Bagolan; Barbara Daniela Iacobelli; Andrea Dotta; Ludovica Martini; Luca Di Chiara; Mauro Magnani; Carlo Federico Perno; Francesca Andreoni; Paola Bernaschi Journal: Antibiotics (Basel) Date: 2022-03-23