Reviewed by Cindy Noyes, MD, University of Vermont Medical Center, Burlington, VT
Stuever and colleagues performed a case-case-control study assessing patient risk factors for carbapenem-resistant Enterobacterales (CRE) infections compared to those with carbapenem-sensitive infections (CSE) and controls from January 2011 through December 2016 in a large metropolitan academic hospital. They identified 432 CRE occurrences, retaining 81 unique cases for analysis and matched these with 87 CSE cases and 89 controls. Those with CRE were 12 times more likely to have received a beta lactam antibiotic compared to controls. Additional factors that were associated with increased odds of CRE versus controls included surgery, numbers of prescriptions of antibiotics, ventilator use, Charlson score >2 and length of stay (LOS). Factors associated with increased odds of CSE compared to controls included antibiotic use, particularly beta lactam antibiotics, Charlson score > 2 and LOS. Multivariate models revealed persistent increase in risk for CRE if patients were prescribed beta lactam antibiotics, experienced increased length of stay and underwent surgery. Risk for CSE was also elevated with above factors though to a lesser degree. Although a single center study, the authors highlight factors associated with increased risk for CRE and may help guide additional study to mitigate risk.
Reference:
Stuever DM, et al (2022). Case-case-control study of risk factors for carbapenem-resistant Enterobacterales infections among hospitalized patients. Antimicrobial Stewardship and Healthcare Epidemiology, https://doi.org/10.1017/ash.2022.244.