{"title":"俄亥俄州一家大型教学医院中产生碳青霉烯酶的肠杆菌:与州立监测机构的比较以及对患者特征的回顾性分析","authors":"Amanda Carroll , Rebekah Carman , Tammy Bannerman , Preeti Pancholi","doi":"10.1016/j.infpip.2024.100366","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>The presence of carbapenemase-producing carbapenem-resistant <em>Enterobacterales</em> (CP-CRE) around the world is increasing, particularly in healthcare settings. Surveillance testing for plasmid-mediated carbapenemase genes is necessary to tracking CP-CRE infections.</p></div><div><h3>Aim</h3><p>In the state of Ohio, surveillance of carbapenem-resistant <em>Enterobacterales</em> (CRE) began in 2018, and to the authors' knowledge data on these cases has not been published to date. This study analyzed data on CRE from a large teaching hospital in Ohio, and by the Ohio Department of Health Laboratory (ODHL).</p></div><div><h3>Methods</h3><p>Carbapenemase production was detected using mCIM, and plasmid-mediated carbapenemase genes were detected using rtPCR. Data was collected on 344 standard-of-care isolates from a large teaching hospital in Ohio, including data collected from chart review. Deidentified surveillance data on 4,391 CRE isolates was provided by the ODHL. Statistical analysis was performed using binary logistic regression.</p></div><div><h3>Findings</h3><p>While KPC was the most common carbapenemase gene (n=1590), NDM (n=98), VIM (n=10), IMP (n=39) and OXA-48 (n=35) were also detected in the isolates studied. <em>Klebsiella pneumoniae</em> and <em>Enterobacter cloacae</em> were the most common CRE, and carbapenemase genes were most commonly detected in <em>K. pneumoniae</em>. Inpatient hospital stays and long-term care were associated with CP-CRE and were more common in women.</p></div><div><h3>Conclusion</h3><p>Surveillance data shows that CP-CRE are present in Ohio, most commonly in <em>Klebsiella pneumoniae</em>. A better understanding of the prevalence of CRE, plasmid-mediated carbapenemase genes present, and the populations affected are important when tracking the spread of disease. Further study and surveillance of carbapenem-resistant organisms can provide a better understanding of their prevalence in the state.</p></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":null,"pages":null},"PeriodicalIF":1.8000,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590088924000301/pdfft?md5=d0c24b68a06f947884147711cd29447a&pid=1-s2.0-S2590088924000301-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Carbapenemase producing Enterobacterales at a large teaching hospital in Ohio: comparison to state surveillance and retrospective analysis of patient characteristics\",\"authors\":\"Amanda Carroll , Rebekah Carman , Tammy Bannerman , Preeti Pancholi\",\"doi\":\"10.1016/j.infpip.2024.100366\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>The presence of carbapenemase-producing carbapenem-resistant <em>Enterobacterales</em> (CP-CRE) around the world is increasing, particularly in healthcare settings. Surveillance testing for plasmid-mediated carbapenemase genes is necessary to tracking CP-CRE infections.</p></div><div><h3>Aim</h3><p>In the state of Ohio, surveillance of carbapenem-resistant <em>Enterobacterales</em> (CRE) began in 2018, and to the authors' knowledge data on these cases has not been published to date. This study analyzed data on CRE from a large teaching hospital in Ohio, and by the Ohio Department of Health Laboratory (ODHL).</p></div><div><h3>Methods</h3><p>Carbapenemase production was detected using mCIM, and plasmid-mediated carbapenemase genes were detected using rtPCR. Data was collected on 344 standard-of-care isolates from a large teaching hospital in Ohio, including data collected from chart review. Deidentified surveillance data on 4,391 CRE isolates was provided by the ODHL. Statistical analysis was performed using binary logistic regression.</p></div><div><h3>Findings</h3><p>While KPC was the most common carbapenemase gene (n=1590), NDM (n=98), VIM (n=10), IMP (n=39) and OXA-48 (n=35) were also detected in the isolates studied. <em>Klebsiella pneumoniae</em> and <em>Enterobacter cloacae</em> were the most common CRE, and carbapenemase genes were most commonly detected in <em>K. pneumoniae</em>. Inpatient hospital stays and long-term care were associated with CP-CRE and were more common in women.</p></div><div><h3>Conclusion</h3><p>Surveillance data shows that CP-CRE are present in Ohio, most commonly in <em>Klebsiella pneumoniae</em>. A better understanding of the prevalence of CRE, plasmid-mediated carbapenemase genes present, and the populations affected are important when tracking the spread of disease. Further study and surveillance of carbapenem-resistant organisms can provide a better understanding of their prevalence in the state.</p></div>\",\"PeriodicalId\":33492,\"journal\":{\"name\":\"Infection Prevention in Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-04-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2590088924000301/pdfft?md5=d0c24b68a06f947884147711cd29447a&pid=1-s2.0-S2590088924000301-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Infection Prevention in Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2590088924000301\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection Prevention in Practice","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2590088924000301","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Carbapenemase producing Enterobacterales at a large teaching hospital in Ohio: comparison to state surveillance and retrospective analysis of patient characteristics
Background
The presence of carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) around the world is increasing, particularly in healthcare settings. Surveillance testing for plasmid-mediated carbapenemase genes is necessary to tracking CP-CRE infections.
Aim
In the state of Ohio, surveillance of carbapenem-resistant Enterobacterales (CRE) began in 2018, and to the authors' knowledge data on these cases has not been published to date. This study analyzed data on CRE from a large teaching hospital in Ohio, and by the Ohio Department of Health Laboratory (ODHL).
Methods
Carbapenemase production was detected using mCIM, and plasmid-mediated carbapenemase genes were detected using rtPCR. Data was collected on 344 standard-of-care isolates from a large teaching hospital in Ohio, including data collected from chart review. Deidentified surveillance data on 4,391 CRE isolates was provided by the ODHL. Statistical analysis was performed using binary logistic regression.
Findings
While KPC was the most common carbapenemase gene (n=1590), NDM (n=98), VIM (n=10), IMP (n=39) and OXA-48 (n=35) were also detected in the isolates studied. Klebsiella pneumoniae and Enterobacter cloacae were the most common CRE, and carbapenemase genes were most commonly detected in K. pneumoniae. Inpatient hospital stays and long-term care were associated with CP-CRE and were more common in women.
Conclusion
Surveillance data shows that CP-CRE are present in Ohio, most commonly in Klebsiella pneumoniae. A better understanding of the prevalence of CRE, plasmid-mediated carbapenemase genes present, and the populations affected are important when tracking the spread of disease. Further study and surveillance of carbapenem-resistant organisms can provide a better understanding of their prevalence in the state.