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Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017
OBJECTIVE: To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. METHODS: Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study usin...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942386/ https://www.ncbi.nlm.nih.gov/pubmed/31911830 http://dx.doi.org/10.1186/s13756-019-0639-7 |
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author | Kotb, Sara Lyman, Meghan Ismail, Ghada Abd El Fattah, Mohammad Girgis, Samia A. Etman, Ahmed Hafez, Soad El-Kholy, Jehan Zaki, Maysaa El Sayed Rashed, Hebat-allah G. Khalil, Ghada M. Sayyouh, Omar Talaat, Maha |
author_facet | Kotb, Sara Lyman, Meghan Ismail, Ghada Abd El Fattah, Mohammad Girgis, Samia A. Etman, Ahmed Hafez, Soad El-Kholy, Jehan Zaki, Maysaa El Sayed Rashed, Hebat-allah G. Khalil, Ghada M. Sayyouh, Omar Talaat, Maha |
author_sort | Kotb, Sara |
collection | PubMed |
description | OBJECTIVE: To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. METHODS: Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study using national HAI surveillance data. Setting: Egyptian hospitals participating in the HAI surveillance system. The patient population included patients admitted to the intensive care unit (ICU) in participating hospitals. Enterobacteriaceae HAI cases were Klebsiella, Escherichia coli, and Enterobacter isolates from blood, urine, wound or respiratory specimen collected on or after day 3 of ICU admission. CRE HAI cases were those resistant to at least one carbapenem. For CRE HAI cases reported during 2011–2017, a hospital-level and patient-level analysis were conducted using only the first CRE isolate by pathogen and specimen type for each patient. For facility, microbiology, and clinical characteristics, frequencies and means were calculated among CRE HAI cases and compared with carbapenem-susceptible Enterobacteriaceae HAI cases through univariate and multivariate logistic regression using STATA 13. RESULTS: There were 1598 Enterobacteriaceae HAI cases, of which 871 (54.1%) were carbapenem resistant. The multivariate regression analysis demonstrated that carbapenem resistance was associated with specimen type, pathogen, location prior to admission, and length of ICU stay. Between 2011 and 2017, there was an increase in the proportion of Enterobacteriaceae HAI cases due to CRE (p-value = 0.003) and the incidence of CRE HAIs (p-value = 0.09). CONCLUSIONS: This analysis demonstrated a high and increasing burden of CRE in Egyptian hospitals, highlighting the importance of enhancing infection prevention and control (IPC) programs and antimicrobial stewardship activities and guiding the implementation of targeted IPC measures to contain CRE in Egyptian ICU’s . |
format | Online Article Text |
id | pubmed-6942386 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69423862020-01-07 Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 Kotb, Sara Lyman, Meghan Ismail, Ghada Abd El Fattah, Mohammad Girgis, Samia A. Etman, Ahmed Hafez, Soad El-Kholy, Jehan Zaki, Maysaa El Sayed Rashed, Hebat-allah G. Khalil, Ghada M. Sayyouh, Omar Talaat, Maha Antimicrob Resist Infect Control Research OBJECTIVE: To describe the epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) healthcare-associated infections (HAI) in Egyptian hospitals reporting to the national HAI surveillance system. METHODS: Design: Descriptive analysis of CRE HAIs and retrospective observational cohort study using national HAI surveillance data. Setting: Egyptian hospitals participating in the HAI surveillance system. The patient population included patients admitted to the intensive care unit (ICU) in participating hospitals. Enterobacteriaceae HAI cases were Klebsiella, Escherichia coli, and Enterobacter isolates from blood, urine, wound or respiratory specimen collected on or after day 3 of ICU admission. CRE HAI cases were those resistant to at least one carbapenem. For CRE HAI cases reported during 2011–2017, a hospital-level and patient-level analysis were conducted using only the first CRE isolate by pathogen and specimen type for each patient. For facility, microbiology, and clinical characteristics, frequencies and means were calculated among CRE HAI cases and compared with carbapenem-susceptible Enterobacteriaceae HAI cases through univariate and multivariate logistic regression using STATA 13. RESULTS: There were 1598 Enterobacteriaceae HAI cases, of which 871 (54.1%) were carbapenem resistant. The multivariate regression analysis demonstrated that carbapenem resistance was associated with specimen type, pathogen, location prior to admission, and length of ICU stay. Between 2011 and 2017, there was an increase in the proportion of Enterobacteriaceae HAI cases due to CRE (p-value = 0.003) and the incidence of CRE HAIs (p-value = 0.09). CONCLUSIONS: This analysis demonstrated a high and increasing burden of CRE in Egyptian hospitals, highlighting the importance of enhancing infection prevention and control (IPC) programs and antimicrobial stewardship activities and guiding the implementation of targeted IPC measures to contain CRE in Egyptian ICU’s . BioMed Central 2020-01-03 /pmc/articles/PMC6942386/ /pubmed/31911830 http://dx.doi.org/10.1186/s13756-019-0639-7 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Kotb, Sara Lyman, Meghan Ismail, Ghada Abd El Fattah, Mohammad Girgis, Samia A. Etman, Ahmed Hafez, Soad El-Kholy, Jehan Zaki, Maysaa El Sayed Rashed, Hebat-allah G. Khalil, Ghada M. Sayyouh, Omar Talaat, Maha Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title | Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title_full | Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title_fullStr | Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title_full_unstemmed | Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title_short | Epidemiology of Carbapenem-resistant Enterobacteriaceae in Egyptian intensive care units using National Healthcare–associated Infections Surveillance Data, 2011–2017 |
title_sort | epidemiology of carbapenem-resistant enterobacteriaceae in egyptian intensive care units using national healthcare–associated infections surveillance data, 2011–2017 |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942386/ https://www.ncbi.nlm.nih.gov/pubmed/31911830 http://dx.doi.org/10.1186/s13756-019-0639-7 |
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