NDLI: Clinical significance and burden of carbapenem-resistant Enterobacterales (CRE) colonization acquisition in hospitalized patients

Content Provider	Springer Nature : BioMed Central
Author	Hassoun-Kheir, Nasreen Hussien, Khetam Karram, Marianne Saffuri, Maram Badaan, Sally Peleg, Shani Aboelhega, Worood Warman, Sigal Alon, Tamar Pollak, Dina Szwarcwort Cohen, Moran Paul, Mical
Abstract	Background Carbapenem-resistant Enterobacterales (CRE) infections have a significant morbidity and mortality toll. The clinical significance and associated burden of CRE colonization rather than infection state are not frequently investigated. We aimed to assess the outcomes of CRE colonized patients compared to matched controls. Methods A secondary analysis of a 1:2 matched case–control study at a tertiary hospital in northern Israel (January-2014 to June-2017). Cases were adults who newly acquired CRE colonization during hospitalization. Controls were inpatients negatively screened for CRE, matched by age, hospitalization division and total days of hospitalization 90 days prior to screening. Our primary outcome was 1-year all-cause mortality. Secondary outcomes included 30-day mortality, diagnosis of any clinical infection, overall days of hospital stay and bloodstream infections all in 1-year follow-up. We estimated crude and propensity score weighted estimates for study outcomes. Results We included a total of 1019 patients: 340 CRE colonized and 679 non-colonized controls. After adjustment, CRE colonization was not associated with increased 1-year mortality (weighted OR 0.98, 95% CI 0.64–1.50, p = 0.936). CRE colonized patients had 1.7 times the odds of clinical infection of any cause (weighted odds ratio (OR) 1.65, 95% CI 1.06–2.56, p = 0.025). CRE colonized patients had increased length of hospital stay compared to controls (weighted OR 1.52, 95%CI 1.10–2.10, p < 0.001) among 1-year survivors. Conclusions CRE colonization may not be independently associated with mortality but with higher risk of clinical infections and longer hospital stays. Infection prevention and antimicrobial stewardship are of utmost importance to prevent acquisition and infections in colonized patients.
Related Links	https://aricjournal.biomedcentral.com/counter/pdf/10.1186/s13756-023-01323-y.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	20472994
DOI	10.1186/s13756-023-01323-y
Journal	Antimicrobial Resistance & Infection Control
Issue Number	1
Volume Number	12
Language	English
Publisher	BioMed Central
Publisher Date	2023-11-20
Access Restriction	Open
Subject Keyword	Medical Microbiology Drug Resistance Infectious Diseases Carbapenem-resistant Enterobacterales Colonization Burden Mortality Bloodstream infection Clinically-significant infections
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Infectious Diseases Microbiology (medical) Pharmacology (medical)
Journal Impact Factor	4.8/2023
5-Year Journal Impact Factor	5.8/2023

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