Detection of carbapenem resistant Enterobacteriaceae in the intensive care unit

Abstract

Objective To investigate the detection of carbapenem resistant Enterobacteriaceae (CRE) in the intensive care unit (ICU) , so as to provide evidences for the clinical treatment and prevention. Methods Data of patients with CRE infection were collected from ICU of the First Hospital of Jiaxing during 2012 to 2017. The detection situation as well as basic features of detected samples and patients was analyzed. Results There were 288 CRE strains detected from 2 231 Enterobacteriaceae strains during 2012-2017 with the CRE detection rate of 12.91%. The detection rate increased from 9.91% in 2012 to 18.26% in 2017, and had an increasing trend year by year (χ2trend=10.070, P <0.01) . The top 2 bacteria in CRE were Klebsiella pneumoniae (122 strains, 42.36%) and Escherichia coli (39 strains, 13.54%) . Detected CRE strains mainly distributed in sputum (44.79%) , and followed by urine and other specimens. CRE detection rate in the patients≥ 60 years old was 18.11% (161/889) , which was higher than that in patients < 60 years old (χ2=35.563, P<0.01) . Among patients hospitalized in the ICU, the detection rate of CRE was significantly higher in patients with lung disease[10.09% (54/535) ], diabetes [9.09% (29/319) ], and malignancy [26.40% (47/178) ] than those without comorbidities (χ2=9.962, 12.340, 14.174, P<0.01) . The hospitalization time [28 (15, 39) d] and mortality rate [8.33% (24/288) ] of patients with CRE infection were both higher than those of carbapenem sensitive Enterobacteriaceae infected people (Z=13.560, χ2=48.655, P both<0.05) . Conclusions The detection rate of CRE is increasing year by year. Patients over 60 years old and combined lung disease, diabetes and malignancy should be paid more attention. Key words: Enterobacteriaceae; Intensive care unit; Detection rate