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Carbapenem-Resistant Enterobacterales Bacteriuria and Subsequent Bacteremia: A Population-Based Study
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Aug 2021
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Source: Infect Control Hosp Epidemiol. 42(8):962-967
[PDF-335.10 KB]
Details:
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Alternative Title:Infect Control Hosp Epidemiol
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Personal Author:
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Description:Objective:
To describe the epidemiology of carbapenem-resistant Enterobacterales (CRE) bacteriuria and determine if urinary catheters increase the risk of subsequent CRE bacteremia.
Design:
Using active population- and laboratory- based surveillance we described a cohort of patients with incident CRE bacteriuria and identified risk factors for developing CRE bacteremia within one year.
Setting:
8 county Georgia Health District 3 (HD3) in Atlanta, GA.
Patients:
Residents of HD3 with CRE first identified in urine between 2012–2017.
Results:
We identified 464 patients with CRE bacteriuria (mean yearly incidence 1.96 cases/100,000 population). Of 425 with chart review, most had a urinary catheter (56%), and many resided in long term care facilities (48%), had a Charlson comorbidity index >3 (38%) or a decubitus ulcer (37%). 21 (5%) patients developed CRE bacteremia with the same organism within one year. Risk factors for subsequent bacteremia included presence of a urinary catheter (odds ratio [OR] 8.0, 95% confidence interval [CI] 1.8–34.9), central venous catheter (OR 4.3, 95% CI 1.7–10.6) or another indwelling device (OR 4.3, 95% CI 1.6–11.4), urine culture obtained as an inpatient (OR 5.7, 95% CI 1.3–25.9) and being in the ICU in the week prior to urine culture (OR 2.9, 95% CI 1.1–7.8). In a multivariable analysis, urinary catheter increased the risk of CRE bacteremia (OR 5.3, 95% CI 1.2–23.6).
Conclusions:
In patients with CRE bacteriuria, urinary catheters increase the risk of CRE bacteremia. Future interventions should target reducing inappropriate insertion and early removal of urinary catheters.
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Subjects:
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Source:
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Pubmed ID:33298218
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Pubmed Central ID:PMC8190175
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Document Type:
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Funding:
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Volume:42
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Issue:8
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