Methods: Active surveillance utilizing rectal cultures was performed August 2013 thru July 2015 with rotating point prevalences on 2-3 units per week in a large tertiary care hospital. 275 patients with Enterobacter sp. or Klebsiella sp. resistant or intermediate to one or more carbapenems isolated from rectal cultures were matched 1:1 with 275 patients of the same Charlson comorbidity score whose rectal surveillance cultures were negative. Univariate and multivariate were used to assess risk factors for CRE colonization
Results: After controlling for patient age, chronic conditions, ICU stay, prior hospitalizations, multiple procedures, and antimicrobial exposures, the risk of having a CRE organism isolated by culture was 5% (95% CI ;1.03-1.08) greater for each additional inpatient admission the patient had in the 36 months prior to identification of CRE. Having a history of liver disease increased the risk of being colonized with CRE by 35% (95% CI; 1.01-1.80). The total number of antimicrobial exposures (orders) given in the prior 12 months increased the risk of having CRE by 1% (95% CI 1.00-1.01)for each additional exposure. Results:
Conclusion: Having a history of liver disease, frequent antimicrobial exposures, or more frequent inpatient admissions are risk factors for colonization with CRE. Knowing a patient’s hospitalization and antimicrobial history in addition to health history may inform CRE surveillance strategies.
C. Passaretti, None
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