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1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study

BACKGROUND: The majority of CRE in Japan are IMP-type carbapenemase-producing CRE (IMP-CRE). However, research on risk factors for the acquisition of IMP-CRE has been limited, and questions exist regarding whether IMP-CRE have risk factors similar to other types of CRE such as KPC. METHODS: We condu...

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Autores principales: Saito, Sho, Hayakawa, Kayoko, Ishikane, Masahiro, Tajima, Taichi, Matsunaga, Nobuaki, Ide, Satoshi, Kinoshita, Noriko, Kusama, Yoshiki, Fujitomo, Yumiko, Nakamoto, Takato, Toda, Yuta, Ohmagari, Norio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252672/
http://dx.doi.org/10.1093/ofid/ofy210.1015
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author Saito, Sho
Hayakawa, Kayoko
Ishikane, Masahiro
Tajima, Taichi
Matsunaga, Nobuaki
Ide, Satoshi
Kinoshita, Noriko
Kusama, Yoshiki
Fujitomo, Yumiko
Nakamoto, Takato
Toda, Yuta
Ohmagari, Norio
author_facet Saito, Sho
Hayakawa, Kayoko
Ishikane, Masahiro
Tajima, Taichi
Matsunaga, Nobuaki
Ide, Satoshi
Kinoshita, Noriko
Kusama, Yoshiki
Fujitomo, Yumiko
Nakamoto, Takato
Toda, Yuta
Ohmagari, Norio
author_sort Saito, Sho
collection PubMed
description BACKGROUND: The majority of CRE in Japan are IMP-type carbapenemase-producing CRE (IMP-CRE). However, research on risk factors for the acquisition of IMP-CRE has been limited, and questions exist regarding whether IMP-CRE have risk factors similar to other types of CRE such as KPC. METHODS: We conducted a matched case–control study involving patients from whom IMP-CRE had been isolated. The controls were selected among patients with carbapenem susceptible Enterobacteriaceae (CSE). Non-meropenem-susceptible per CLSI criteria and/or ceftazidime-resistant Enterobacteriaceae were screened, and metallo-β-lactamase–positive isolates were examined for bla(IMP) by PCR (January 2012 to December 2016). RESULTS: Ninety-six patients with CRE were matched with 96 patients with CSE. They comprised Enterobacter sp. (n = 132 [CRE: 66, CSE: 66], 68.8%) and Klebsiella pneumoniae (n = 60 [CRE:30, CSE:30], 31.2%), and bacteria were most commonly isolated from sputum (n = 76 [39.6%]), followed by urine (n = 62 [32.3%]). Background factors such as age (median = 75 [IQR: 66–84]), sex (male = 56.8%), and the Charlson comorbidity index (median = 2 [IQR: 1–3.8]) were similar between CRE and CSE. In multivariate analysis, independent risk factors were identified: history of gastrointestinal (GI) endoscopy or surgery, history of ICU stay, and a previous exposure within 1 month to penicillins with β-lactamase inhibitors, cephalosporines, or carbapabnems. CONCLUSION: Histories of GI endoscopy and ICU stay as well as broad-spectrum antimicrobial exposure were identified as risk factors for CRE isolation. Infection control measures combined with enhanced antimicrobial stewardship are key to preventing the spread of IMP-CRE. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62526722018-11-28 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study Saito, Sho Hayakawa, Kayoko Ishikane, Masahiro Tajima, Taichi Matsunaga, Nobuaki Ide, Satoshi Kinoshita, Noriko Kusama, Yoshiki Fujitomo, Yumiko Nakamoto, Takato Toda, Yuta Ohmagari, Norio Open Forum Infect Dis Abstracts BACKGROUND: The majority of CRE in Japan are IMP-type carbapenemase-producing CRE (IMP-CRE). However, research on risk factors for the acquisition of IMP-CRE has been limited, and questions exist regarding whether IMP-CRE have risk factors similar to other types of CRE such as KPC. METHODS: We conducted a matched case–control study involving patients from whom IMP-CRE had been isolated. The controls were selected among patients with carbapenem susceptible Enterobacteriaceae (CSE). Non-meropenem-susceptible per CLSI criteria and/or ceftazidime-resistant Enterobacteriaceae were screened, and metallo-β-lactamase–positive isolates were examined for bla(IMP) by PCR (January 2012 to December 2016). RESULTS: Ninety-six patients with CRE were matched with 96 patients with CSE. They comprised Enterobacter sp. (n = 132 [CRE: 66, CSE: 66], 68.8%) and Klebsiella pneumoniae (n = 60 [CRE:30, CSE:30], 31.2%), and bacteria were most commonly isolated from sputum (n = 76 [39.6%]), followed by urine (n = 62 [32.3%]). Background factors such as age (median = 75 [IQR: 66–84]), sex (male = 56.8%), and the Charlson comorbidity index (median = 2 [IQR: 1–3.8]) were similar between CRE and CSE. In multivariate analysis, independent risk factors were identified: history of gastrointestinal (GI) endoscopy or surgery, history of ICU stay, and a previous exposure within 1 month to penicillins with β-lactamase inhibitors, cephalosporines, or carbapabnems. CONCLUSION: Histories of GI endoscopy and ICU stay as well as broad-spectrum antimicrobial exposure were identified as risk factors for CRE isolation. Infection control measures combined with enhanced antimicrobial stewardship are key to preventing the spread of IMP-CRE. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6252672/ http://dx.doi.org/10.1093/ofid/ofy210.1015 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Saito, Sho
Hayakawa, Kayoko
Ishikane, Masahiro
Tajima, Taichi
Matsunaga, Nobuaki
Ide, Satoshi
Kinoshita, Noriko
Kusama, Yoshiki
Fujitomo, Yumiko
Nakamoto, Takato
Toda, Yuta
Ohmagari, Norio
1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title_full 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title_fullStr 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title_full_unstemmed 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title_short 1182. Risk Factors for the Acquisition of IMP-Type Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae in Japan: A Matched Case–control Study
title_sort 1182. risk factors for the acquisition of imp-type carbapenemase-producing carbapenem-resistant enterobacteriaceae in japan: a matched case–control study
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252672/
http://dx.doi.org/10.1093/ofid/ofy210.1015
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