With the increasing use of carbapenems in clinic practice, carbapenem-resistant Enterobacteriaceae (CRE) has also increased, thus posing a significant threat to human health.
To assess the effects of CRE colonization active screening and various CRE patient placements implemented in decreasing CRE infection risk.
CRE colonization screening and various CRE patient placements were performed across CRE high-risk departments (PICU, NICU, neonatal wards and hematology departments) between 2017 and 2018, respectively.
In 2018, more than 80% neonatal CRE positive patients were isolated using single room or same room isolation, and more than 50% non-neonatal patients were, with no cohort placement. The CRE nosocomial infection incidences decreased from 1.96% to 0.63% in NICU, and from 0.57% to 0.30% in neonatal wards (all P<0.05) while no significant changes were found in the other departments. The CRE colonization incidence at different length hospital stay (LOS) decreased at 8-14days and >14days LOS in CRE high-risk departments (all P<0.05). In addition, 62.5% clinical strains, 66.7% screening strains, and 74.1% nosocomial infection strains were belonged to CC17 complex group in neonatal isolates; while, 56.6%, 47.5% and 100% strains mentioned above were belonged to CC11 complex group in non-neonatal isolates respectively. The predominant carbapenemase gene was bla (98%) in neonatal and bla (70%) in non-neonatal CR-KP stains.
Active CRE colonization surveillance and CRE positive patient propriety placement may decrease the CRE infection risk. Neonatal and non-neonatal CR-KP isolates showed different CRE molecular characteristics, which could further benefit CRE infection precaution and antibiotic therapy.
Copyright © 2020. Published by Elsevier Ltd.
About The Expert
Lijun Yin
Leiyan He
Jin Miao
Weiqing Yang
Xiaohua Wang
Jian Ma
Nana Wu
Yun Cao
Laishuan Wang
Guoping Lu
Liling Li
Chunmei Lu
Jing Hu
Lei Zhang
Bing Zhao
Xiaowen Zhai
Chuanqing Wang
References
PubMed