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Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017
- Source :
- Antimicrobial Resistance and Infection Control, Vol 9, Iss 1, Pp 1-9 (2020), Antimicrobial Resistance and Infection Control
- Publication Year :
- 2020
- Publisher :
- BMC, 2020.
-
Abstract
- Objective To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. Methods Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study using national HAI surveillance data. Setting: Egyptian hospitals participating in the HAI surveillance system. The patient population included patients admitted to the intensive care unit (ICU) in participating hospitals. Enterobacteriaceae HAI cases were Klebsiella, Escherichia coli, and Enterobacter isolates from blood, urine, wound or respiratory specimen collected on or after day 3 of ICU admission. CRE HAI cases were those resistant to at least one carbapenem. For CRE HAI cases reported during 2011–2017, a hospital-level and patient-level analysis were conducted using only the first CRE isolate by pathogen and specimen type for each patient. For facility, microbiology, and clinical characteristics, frequencies and means were calculated among CRE HAI cases and compared with carbapenem-susceptible Enterobacteriaceae HAI cases through univariate and multivariate logistic regression using STATA 13. Results There were 1598 Enterobacteriaceae HAI cases, of which 871 (54.1%) were carbapenem resistant. The multivariate regression analysis demonstrated that carbapenem resistance was associated with specimen type, pathogen, location prior to admission, and length of ICU stay. Between 2011 and 2017, there was an increase in the proportion of Enterobacteriaceae HAI cases due to CRE (p-value = 0.003) and the incidence of CRE HAIs (p-value = 0.09). Conclusions This analysis demonstrated a high and increasing burden of CRE in Egyptian hospitals, highlighting the importance of enhancing infection prevention and control (IPC) programs and antimicrobial stewardship activities and guiding the implementation of targeted IPC measures to contain CRE in Egyptian ICU’s .
- Subjects :
- Male
0301 basic medicine
Carbapenem
Databases, Factual
Carbapenem-resistant enterobacteriaceae
Urine
Antimicrobial resistance
law.invention
Antimicrobial Stewardship
0302 clinical medicine
Risk Factors
law
Epidemiology
Infection control
Antimicrobial stewardship
Pharmacology (medical)
030212 general & internal medicine
Child
Cross Infection
Incidence (epidemiology)
Enterobacteriaceae Infections
virus diseases
Middle Aged
Intensive care unit
Intensive Care Units
Blood
Infectious Diseases
Child, Preschool
Population Surveillance
Egypt
Female
medicine.drug
Adult
Microbiology (medical)
medicine.medical_specialty
animal structures
Adolescent
030106 microbiology
Healthcare-associated infections
lcsh:Infectious and parasitic diseases
Young Adult
03 medical and health sciences
Intensive care
medicine
Humans
lcsh:RC109-216
Retrospective Studies
Carbapenem resistance Enterobacteriaceae
business.industry
Research
Public Health, Environmental and Occupational Health
Infant
Carbapenem-Resistant Enterobacteriaceae
Emergency medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 20472994
- Volume :
- 9
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Antimicrobial Resistance and Infection Control
- Accession number :
- edsair.doi.dedup.....fd2fc84b3d524ef84bdfcca83bdffa4e