Abstract
Objective: Since 1991, carbapenem resistance is being reported in an increasing fashion worldwide. It is expected to increase due to increasing frequency of international travels. Carbapenem resistant Escherichia coli and Klebsiella pneumoniae can cause colonization or clinical infection. Treatment of carbapenem resistant Escherichia coli or Klebsiella pneumoniae is not precise and we have limited choices of antibiotics. This brings increasing morbidity and mortality with itself. We aimed to find out risk factors for colonization or infection with carbapenem resistant Escherichia coli and Klebsiella pneumoniae in this study. 
 Materials and Methods: With the decision of Adult Hospital Infection Control Comittee, a surveillance has been started among adult patients (>18 years of age) at Hacettepe University Hospitals at June 2009. A perianal swab culture has been obtained weekly by Adult Hospital Infection Control nurses from patients included in surveillance program. In this study, carried on adult patients hospitalized at Hacettepe University hospitals between 01.06.2009-31.12.2010, risk factors for colonization or infection with carbapenem resistant Escherichia coli and Klebsiella pneumoniae, those are detected via surveillance cultures or clinical specimens, were investigated. 
 Results: According to results of the multivariate analysis of the study; being hospitalized in an internal ward (any ward other than a surgical ward) (p=0,005), Diabetes Mellitus (p=0,010), immunosuppression (p<0,001), hospitalization history (p<0,005), burn history (p=0,026), central venous line history (p=0,012), arterial line history (p=0,010), feeding or nasogastric tube history (p<0,001), sulbactam/ampicillin use (p<0,001), glycopeptide use (p=0,003) and carbapenem or piperacillin/tazobactam use (p<0,001) were all detected to be risk factors.
Highlights
Gram-negative bacteria are still among leading factors in both community-based and health-care-associated infections
Carbapenem resistance has been reported in E. coli and K. pneumoniae strains at many centers in our country, epidemiological studies to identify risk factors for colonization / infections of these microorganisms are limited
K. pneumoniae / E.coli was detected in 130 cases (93 carbapenem resistant K. pneumoniae, 37 carbapenem resistant E. coli) in perianal culture and 12 clinical specimens in file records
Summary
Gram-negative bacteria are still among leading factors in both community-based and health-care-associated infections. In March 2009, recommendations for controlling carbapenem resistant Enterobacteriaceae were published by Centers for Disease Control and Prevention in hospitals[18] Taking these suggestions into account, an active surveillance program has been initiated to detect infected or colonized patients with carbapenem resistant E. coli or K. pneumoniae in Hacettepe University Adult and Oncology Hospitals. It was aimed to determine the risk factors for carbapenem resistant E. coli and K. pneumoniae infection/colonization in adult patients in Hacettepe University Hospitals by comparing the cases covered by the above mentioned surveillance program with the appropriate control patients. Adult patients (> 18 years of age) with carbapenem resistant E. coli or K. pneumoniae in at least one perianal swab culture or one of their clinical specimens, hospitalized for> 72 hours between 01.06.2009 and 31.12.2010 in the units covered by the surveillance, were accepted as case. For p
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