Fecal carriage of carbapenem-resistant Enterobacteriaceae in a Chinese university hospital.
BACKGROUND
Carbapenem-resistant Enterobacteriaceae (CRE) is widespread in China. To date, no study available has specifically determined the prevalence and risk factors of inpatients with CRE intestinal colonization in this region.


METHODS
Stool samples were screened for the presence of CRE in a Chinese university hospital. A case-control study was performed to identify risk factors associated with CRE fecal colonization. Case patients were those who had CRE colonization. Control subjects had no microbiologic evidence of CRE colonization. Clinical data were obtained from the medical record.


RESULTS
The prevalence of CRE was 6.6% (20/303 patients), of which 8 had carbapenemase-producing isolates. KPC-2, IMP-4, and NDM-1 were detected from these isolates. Hospital readmissions (odds ratio [OR], 58.067; 95% confidence interval [95% CI]: 5.517-611.134; P = .001), sickbed changes (OR, 45.904; 95% CI: 8.484-248.376; P < .001), invasive procedures (OR, 8.322; 95% CI: 1.996-34.690; P = .004), and vancomycin (OR, 11.552; 95% CI: 1.155-115.574; P = .037) were independently associated with CRE colonization.


CONCLUSIONS
This study demonstrated that asymptomatic intestinal carriage of CRE was relatively common in one region of China. Our study suggested that the implementation of effective infection control measures is urgently required to control the transmission of CRE in health care facilities in this country.
Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Zhi-chang
ZC
Zhao
Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Xiao-hong
XH
Xu
Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Mao-bai
MB
Liu
Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Juan
J
Wu
Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
Juan
J
Lin
Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, Fujian, China. Electronic address: leonlee307@hotmail.com.
Bin
B
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult; D018440:beta-Lactam Resistance
D000900:Anti-Bacterial Agents; D015780:Carbapenems
Carbapenemases; Fecal colonization; Risk factors