ENTEROBACTERIA Resistant to Carbapenems in Two Hospitals in the Metropolitan Area of ​​Vitória-ES and its Associated Factors

Name: LILIAN SILVA LAVAGNOLI

Publication date: 31/05/2016
Advisor:

Namesort descending Role
CRISPIM CERUTTI JUNIOR Advisor *

Examining board:

Namesort descending Role
ANGELICA ESPINOSA BARBOSA MIRANDA Internal Examiner *
BLIMA FUX Internal Alternate *
CRISPIM CERUTTI JUNIOR Advisor *

Summary: There have been worldwide reports of carbapenem-resistant Enterobacteriaceae (CRE), indicating that the spread of resistance has become a major public health problem. A better understanding of the issues involved, including the risk factors for infection by these microorganisms, is therefore required. The aim of the present exploratory case-control study was to identify possible risk factors for acquisition of Enterobacterial strains with a marker for resistance to carbapenems. The study population consisted of patients with biological samples that tested positive for CRE with the disk diffusion test and Etest and controls with CRE-negative biological samples. In all, 65 patients were included: 13 (20%) with CRE and 52 (80%) without. The CRE isolated were Serratia marcescens (6), Klebsiella pneumoniae (4) and Enterobacter cloacae (3). Univariate analysis revealed that length of hospitalization prior to sample collection (p<0.001), total length of stay (p<0.001) and surgical procedure (p=0.004) were statistically significant risk factors. In the logistic regression model, length of stay prior to sample collection was still significant, with an odds ratio of 0.934 (95% CI: 0.882 to 0.989). Surgical procedure was of borderline significance (p = 0.056; OR = 9.293; 95% CI: 0.946 to 91.255). Separate analysis of carbapenem use showed a statistically significant association (p <0.001), however, it was not maintained in the multivariate analysis, which resulted in an odds ratio of 0.91 (95% CI: 0.752 to 47.63). A knowledge of the risk factors for infection by CRE and implementation of preventive measures could play a decisive role in reducing the spread of these microorganisms in hospital settings.

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