Epidemiological characteristics of carbapenem-resistant Enterobacteriaceae and carbapenem-resistant Acinetobacter baumannii in a tertiary referral hospital in Korea

韩国一家三级转诊医院中耐碳青霉烯类肠杆菌科细菌和耐碳青霉烯类鲍曼不动杆菌的流行病学特征

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Abstract

OBJECTIVES: This study aimed to identify the epidemiological characteristics of patients with carbapenem-resistant Enterobacteriaceae and Acinetobacter baumannii (CRE/ CRAB) isolates in a tertiary referral hospital in Korea. METHODS: We collected and analyzed data from 528 adults admitted to a tertiary referral hospital from August 1, 2018 to February 29, 2020. The CRE/CRAB isolates were confirmed as being present at the time of patients' admission or acquired during hospitalization based on their medical records. The t-test, chi-square test, or Fisher exact test and stepwise multiple logistic regression were performed. RESULTS: While the proportion of community-acquired CRE/CRAB was low (6%), 20% of CRE/ CRAB isolates were identified in patients at the time of hospitalization. The risk of CRAB isolation was positively associated with mechanical ventilator use (odds ratio [OR], 3.52; 95% confidence interval [CI], 1.96-6.33) and total parenteral nutrition use (OR, 3.64; 95% CI, 1.87-7.08). CONCLUSION: Over 20% of CRE/CRAB isolates in a tertiary referral hospital in Korea were found at the time of patients' admission. Furthermore, patients with mechanical ventilation and/or total parenteral nutrition tended to acquire CRAB more frequently. Thus, active surveillance for CRE/CRAB at the time of hospitalization is strongly required, particularly for patients who are expected to require mechanical ventilation or total parenteral nutrition.

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