Rectal screening for carbapenemase-producing Enterobacteriaceae in an intensive care unit in India

Objectives: To determine the proportion of patients admitted to ICU who are colonised with carbapenem-resistant Enterobacteriaceae (CRE) and to estimate the agreement between colonised patients and patients who developed an infection with CRE.Design: Prospective surveillance studySetting: The ICU of a tertiary care hospital in Kerala, IndiaParticipants: All patients above 18 were admitted to the ICU during the study period.Outcome measures: Patients colonised with CRE and systemic infection with the colonised organismResults: CRE colonisation was found in 20(8.7%) samples. Among the 20 patients in the study who were colonised with CRE, 5(25%) developed systemic infection due to CRE. History of antibiotic usage and admission to other hospitals in the last 90 days were independent predictors of CRE colonisation.Conclusion: Five of the 20 patients colonised with CRE developed an infection. Hospital admission and antibiotic usage were the main risk factors associated with CRE colonisation. Antibiotic escalation was suggested for two colonised patients based on their clinical worsening, but they succumbed to the illness. This study led us to modify our infection control practices, which led to isolating patients colonised with CRE.