Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh
{"title":"重症监护病房耐碳青霉烯肠杆菌科菌血症:危险因素和临床结果的描述性研究","authors":"Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh","doi":"10.31436/imjm.v22i4.2272","DOIUrl":null,"url":null,"abstract":"INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome\",\"authors\":\"Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh\",\"doi\":\"10.31436/imjm.v22i4.2272\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.\",\"PeriodicalId\":53575,\"journal\":{\"name\":\"International Medical Journal Malaysia\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Medical Journal Malaysia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.31436/imjm.v22i4.2272\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Medical Journal Malaysia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.31436/imjm.v22i4.2272","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome
INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.
期刊介绍:
International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.