{"title":"耐碳青霉烯肠杆菌感染的危险因素：一项病例对照研究。","authors":"Sibongakonke Mbele, Sandeep D Vasaikar","doi":"10.4102/safp.v67i1.6029","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports available with a focus on identifying risk factors for CRE infections by comparing CRE cases with controls. The aim is to evaluate factors associated with CRE infections among individuals admitted to hospitals in Mthatha.</p><p><strong>Methods: </strong>A retrospective case-control study among patients who attended Nelson Mandela Academic Hospital (NMAH) and Mthatha Regional Hospital (MRH), Eastern Cape, South Africa. Demographic, medical history and current hospitalisation factors were captured on clinical research forms. GraphPad Prism version 8 software was used for statistical analysis.</p><p><strong>Results: </strong>Out of the 226 participants with CRE infection, CRE cases were more likely than controls to be adults (51.9%, odds ratio [OR]: 1.34, 95% confidence interval [CI]: 0.72-2.55) and of male sex (54.9%, OR: 1.48, 95% CI: 0,87-2,45). Significant risk factors for CRE infections included underlying illnesses (OR: 2.55, 95% CI: 1.41-4.60, p = 0.002), urine catheterisation (OR: 5.40, 95% CI: 1.45-18.33, p = 0.01), intravascular devices (OR: 2.48, 95% CI: 1.06-6.03, p = 0.05) and prolonged hospital stay (OR: 1.87, 95% CI: 1.01-3.39, p = 0.048). CRE cases compared to controls were almost twice as likely to demise or have an extended hospital stay of more than one month. Klebsiella pneumoniae (62.6%) and Enterobacter cloacae (60.6%) were prevalent Enterobacterales associated with CRE.</p><p><strong>Conclusion: </strong>Significant risk factors for CRE infections are underlying illnesses, urine catheterisation, intravascular devices and prolonged hospitalisation.Contribution: The complicated nature of CRE infections highlights the importance of targeted interventions to mitigate their spread and impact on public health.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"67 1","pages":"e1-e10"},"PeriodicalIF":1.2000,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886460/pdf/","citationCount":"0","resultStr":"{\"title\":\"Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study.\",\"authors\":\"Sibongakonke Mbele, Sandeep D Vasaikar\",\"doi\":\"10.4102/safp.v67i1.6029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports available with a focus on identifying risk factors for CRE infections by comparing CRE cases with controls. The aim is to evaluate factors associated with CRE infections among individuals admitted to hospitals in Mthatha.</p><p><strong>Methods: </strong>A retrospective case-control study among patients who attended Nelson Mandela Academic Hospital (NMAH) and Mthatha Regional Hospital (MRH), Eastern Cape, South Africa. Demographic, medical history and current hospitalisation factors were captured on clinical research forms. GraphPad Prism version 8 software was used for statistical analysis.</p><p><strong>Results: </strong>Out of the 226 participants with CRE infection, CRE cases were more likely than controls to be adults (51.9%, odds ratio [OR]: 1.34, 95% confidence interval [CI]: 0.72-2.55) and of male sex (54.9%, OR: 1.48, 95% CI: 0,87-2,45). Significant risk factors for CRE infections included underlying illnesses (OR: 2.55, 95% CI: 1.41-4.60, p = 0.002), urine catheterisation (OR: 5.40, 95% CI: 1.45-18.33, p = 0.01), intravascular devices (OR: 2.48, 95% CI: 1.06-6.03, p = 0.05) and prolonged hospital stay (OR: 1.87, 95% CI: 1.01-3.39, p = 0.048). CRE cases compared to controls were almost twice as likely to demise or have an extended hospital stay of more than one month. Klebsiella pneumoniae (62.6%) and Enterobacter cloacae (60.6%) were prevalent Enterobacterales associated with CRE.</p><p><strong>Conclusion: </strong>Significant risk factors for CRE infections are underlying illnesses, urine catheterisation, intravascular devices and prolonged hospitalisation.Contribution: The complicated nature of CRE infections highlights the importance of targeted interventions to mitigate their spread and impact on public health.</p>\",\"PeriodicalId\":22040,\"journal\":{\"name\":\"South African Family Practice\",\"volume\":\"67 1\",\"pages\":\"e1-e10\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-02-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886460/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"South African Family Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4102/safp.v67i1.6029\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"South African Family Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4102/safp.v67i1.6029","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：多年来，碳青霉烯耐药肠杆菌（CRE）在全球范围内发展，对全球健康构成重大威胁。先前的研究强调以前使用抗生素和延长住院时间是CRE感染的主要危险因素。然而，通过比较CRE病例与对照组来确定CRE感染的危险因素的报告有限。目的是评估与Mthatha住院患者感染CRE相关的因素。方法：在南非东开普省纳尔逊曼德拉学术医院（NMAH）和姆塔塔地区医院（MRH）就诊的患者中进行回顾性病例对照研究。在临床研究表格中记录了人口统计、病史和目前的住院因素。采用GraphPad Prism version 8软件进行统计分析。结果：在226名CRE感染的参与者中，CRE病例比对照组更可能是成年人（51.9%，优势比[OR]: 1.34, 95%可信区间[CI]: 0.72-2.55）和男性（54.9%,OR: 1.48, 95% CI: 0,87-2,45）。CRE感染的重要危险因素包括基础疾病（OR: 2.55, 95% CI: 1.41-4.60, p = 0.002）、导尿（OR: 5.40, 95% CI: 1.45-18.33, p = 0.01）、血管内装置（OR: 2.48, 95% CI: 1.06-6.03, p = 0.05）和住院时间延长（OR: 1.87, 95% CI: 1.01-3.39, p = 0.048）。与对照组相比，CRE病例死亡或住院时间超过一个月的可能性几乎是对照组的两倍。肺炎克雷伯菌（62.6%）和阴沟肠杆菌（60.6%）是与CRE相关的常见肠杆菌。结论：CRE感染的重要危险因素是基础疾病、导尿、血管内装置和长期住院。贡献：CRE感染的复杂性突出了有针对性的干预措施的重要性，以减轻其传播和对公共卫生的影响。
Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study.
Background: Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports available with a focus on identifying risk factors for CRE infections by comparing CRE cases with controls. The aim is to evaluate factors associated with CRE infections among individuals admitted to hospitals in Mthatha.
Methods: A retrospective case-control study among patients who attended Nelson Mandela Academic Hospital (NMAH) and Mthatha Regional Hospital (MRH), Eastern Cape, South Africa. Demographic, medical history and current hospitalisation factors were captured on clinical research forms. GraphPad Prism version 8 software was used for statistical analysis.
Results: Out of the 226 participants with CRE infection, CRE cases were more likely than controls to be adults (51.9%, odds ratio [OR]: 1.34, 95% confidence interval [CI]: 0.72-2.55) and of male sex (54.9%, OR: 1.48, 95% CI: 0,87-2,45). Significant risk factors for CRE infections included underlying illnesses (OR: 2.55, 95% CI: 1.41-4.60, p = 0.002), urine catheterisation (OR: 5.40, 95% CI: 1.45-18.33, p = 0.01), intravascular devices (OR: 2.48, 95% CI: 1.06-6.03, p = 0.05) and prolonged hospital stay (OR: 1.87, 95% CI: 1.01-3.39, p = 0.048). CRE cases compared to controls were almost twice as likely to demise or have an extended hospital stay of more than one month. Klebsiella pneumoniae (62.6%) and Enterobacter cloacae (60.6%) were prevalent Enterobacterales associated with CRE.
Conclusion: Significant risk factors for CRE infections are underlying illnesses, urine catheterisation, intravascular devices and prolonged hospitalisation.Contribution: The complicated nature of CRE infections highlights the importance of targeted interventions to mitigate their spread and impact on public health.
期刊介绍：
South African Family Practice (SAFP) is a peer-reviewed scientific journal, which strives to provide primary care physicians and researchers with a broad range of scholarly work in the disciplines of Family Medicine, Primary Health Care, Rural Medicine, District Health and other related fields. SAFP publishes original research, clinical reviews, and pertinent commentary that advance the knowledge base of these disciplines. The content of SAFP is designed to reflect and support further development of the broad basis of these disciplines through original research and critical review of evidence in important clinical areas; as well as to provide practitioners with continuing professional development material.
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