Merit Research Journal of Medicine and Medical Sciences (ISSN: 2354-323X) Vol. 8(5) pp. 120-124, May, 2020
Available online http://www.meritresearchjournals.org/mms/index.htm
Copyright © 2020 Merit Research Journals
Original Research Article
Risk Factors in Carbapenem Resistant
Enterobacteriaceae Infections
Mehmet Zeki Kortak
1
, Fatma Bozkurt
2
, Özcan Deveci
3*
, Ciğdem Mermutlu
4
, Recep Tekin
4
,
Mustafa Kemal Çelen
4
and Saim Dayan
4
Abstract
1
Department of Infectious Disease
and Clinical Microbiology, Ercis State
Hospital, Van, Turkey
2
Department of Infectious Disease
and Clinical Microbiology, Gazi
Yaşargil Training and Research
Hospital, Diyarbakir, Turkey
3
Department of Infectious Diseases
and Clinical Microbiology, Medical
Park Hospital, Batman, Turkey
4
Department of Infectious Diseases
and Clinical Microbiology, Dicle
University Medical Faculty ,
Diyarbakir, Turkey.
*Corresponding Author’s Email:
ozcandeveci1@hotmail.com
Carbapenem resistance, which was rarely observed up until the recent years, is
becoming increasingly more common among the Enterobacteriaceae family around
the world. It is thought that specifying the risk factors for carbapenem-resistant
Enterobacteriaceae (CRE) infections may be helpful to initiate the appropriate
empirical therapy at an early phase and to take the infection control measures. The
aim of this study is to observe the risk factors and their relationship with mortality in
patients infected with CRE. The control group was randomly selected from amongst
the patients who were admitted to the same ward with the patient group during the
period when CRE growth was observed, but were tested negative for CRE growth.
Two control subjects were enrolled for each patient. Seventy patients where CRE
growth was observed were included in the study. Among these patients, 55 were
infected with K.pneumoniae, 7 with E.coli, 6 with Enterobacter cloacae, 1 with
Enterobacter asburiae and one patient was infected with Enterobacter aerogenes.
Immunosuppression, endotracheal intubation, mechanical ventilation, urinary
neumonia des n, total parenteral nutrition (TPN), central venous catheter (CVC),
tracheostomy, urinary catheter days before CRE, endotracheal intubation days,
ventilator-days, CVC days, TPN days, days of nasogastric intubation, days of
abdominal drain were found to be statistically significant. Also, the number of days
spent in intensive care before CRE developed, the Acute Physiology And Chronic
Health Evaluation II (APACHE II) score; and days of piperacillin/tazobactam,
carbapenem, Colistin, and neumonia des use were found to be significant. In order
to reduce the infections that happen due to CRE, the surveillance results should be
continuously monitored and the recommendations of the infection control committee
should be taken under consideration. The indication of invasive procedures should
procedures be well-defined and unnecessary invasive procedures should be
avoided. In patients who will receive therapy, treatment should be initiated according
to the rational antibiotic use principle.
Keywords: Carbapenem-Resistant Enterobacteriaceae, Mortality, Risk Factors
INTRODUCTION
Microorganisms in the Enterobacteriaceae family consist
of a large number of medically important gram-negative
(GN) bacteria that form the gastrointestinal flora. These
microorganisms are among the most common pathogens
that cause infections in humans, such as, cystitis,
pyelonephritis, septicemia, pneumonia, device-related
infections, peritonitis and meningitis. Furthermore,
pathogens in the Enterobacteriaceae family are the
source of community and hospital-acquired infections
(Nordmann et al., 2011). Carbapenem antibiotics became
an important treatment in the severe infections caused by
gram-negative bacteria, due to the resistance developed
towards the antibiotics in the beta-lactamase group
and subsequent production of extended-spectrum beta-