Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study

Background: Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports...

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Main Authors: Sibongakonke Mbele, Sandeep D. Vasaikar
Format: Article
Language:English
Published: AOSIS 2025-02-01
Series:South African Family Practice
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Online Access:https://safpj.co.za/index.php/safpj/article/view/6029
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author Sibongakonke Mbele
Sandeep D. Vasaikar
author_facet Sibongakonke Mbele
Sandeep D. Vasaikar
author_sort Sibongakonke Mbele
collection DOAJ
description Background: Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports available with a focus on identifying risk factors for CRE infections by comparing CRE cases with controls. The aim is to evaluate factors associated with CRE infections among individuals admitted to hospitals in Mthatha. Methods: A retrospective case-control study among patients who attended Nelson Mandela Academic Hospital (NMAH) and Mthatha Regional Hospital (MRH), Eastern Cape, South Africa. Demographic, medical history and current hospitalisation factors were captured on clinical research forms. GraphPad Prism version 8 software was used for statistical analysis. Results: Out of the 226 participants with CRE infection, CRE cases were more likely than controls to be adults (51.9%, odds ratio [OR]: 1.34, 95% confidence interval [CI]: 0.72–2.55) and of male sex (54.9%, OR: 1.48, 95% CI: 0,87–2,45). Significant risk factors for CRE infections included underlying illnesses (OR: 2.55, 95% CI: 1.41–4.60, p = 0.002), urine catheterisation (OR: 5.40, 95% CI: 1.45–18.33, p = 0.01), intravascular devices (OR: 2.48, 95% CI: 1.06–6.03, p = 0.05) and prolonged hospital stay (OR: 1.87, 95% CI: 1.01–3.39, p = 0.048). CRE cases compared to controls were almost twice as likely to demise or have an extended hospital stay of more than one month. Klebsiella pneumoniae (62.6%) and Enterobacter cloacae (60.6%) were prevalent Enterobacterales associated with CRE. Conclusion: Significant risk factors for CRE infections are underlying illnesses, urine catheterisation, intravascular devices and prolonged hospitalisation. Contribution: The complicated nature of CRE infections highlights the importance of targeted interventions to mitigate their spread and impact on public health.
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spelling doaj-art-25f7609df8be493895cacc9d3484c4e52025-02-11T13:26:42ZengAOSISSouth African Family Practice2078-61902078-62042025-02-01671e1e1010.4102/safp.v67i1.60294867Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control studySibongakonke Mbele0Sandeep D. Vasaikar1Department of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, MthathaDepartment of Laboratory Medicine and Pathology, Faculty of Medicine and Health Sciences, Walter Sisulu University, MthathaBackground: Over years, concerning Carbapenem-resistant Enterobacterales (CRE) have advanced globally, posing a major threat to global health. Prior studies highlight previous antibiotic use and prolonged hospital stays as paramount risk factors for CRE infections. However, there are limited reports available with a focus on identifying risk factors for CRE infections by comparing CRE cases with controls. The aim is to evaluate factors associated with CRE infections among individuals admitted to hospitals in Mthatha. Methods: A retrospective case-control study among patients who attended Nelson Mandela Academic Hospital (NMAH) and Mthatha Regional Hospital (MRH), Eastern Cape, South Africa. Demographic, medical history and current hospitalisation factors were captured on clinical research forms. GraphPad Prism version 8 software was used for statistical analysis. Results: Out of the 226 participants with CRE infection, CRE cases were more likely than controls to be adults (51.9%, odds ratio [OR]: 1.34, 95% confidence interval [CI]: 0.72–2.55) and of male sex (54.9%, OR: 1.48, 95% CI: 0,87–2,45). Significant risk factors for CRE infections included underlying illnesses (OR: 2.55, 95% CI: 1.41–4.60, p = 0.002), urine catheterisation (OR: 5.40, 95% CI: 1.45–18.33, p = 0.01), intravascular devices (OR: 2.48, 95% CI: 1.06–6.03, p = 0.05) and prolonged hospital stay (OR: 1.87, 95% CI: 1.01–3.39, p = 0.048). CRE cases compared to controls were almost twice as likely to demise or have an extended hospital stay of more than one month. Klebsiella pneumoniae (62.6%) and Enterobacter cloacae (60.6%) were prevalent Enterobacterales associated with CRE. Conclusion: Significant risk factors for CRE infections are underlying illnesses, urine catheterisation, intravascular devices and prolonged hospitalisation. Contribution: The complicated nature of CRE infections highlights the importance of targeted interventions to mitigate their spread and impact on public health.https://safpj.co.za/index.php/safpj/article/view/6029carbapenem-resistant enterobacteriaceae (cre)carbapenem-resistant enterobacterales (cre)cre infectionscre risk factorscarbapenemase genes.
spellingShingle Sibongakonke Mbele
Sandeep D. Vasaikar
Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
South African Family Practice
carbapenem-resistant enterobacteriaceae (cre)
carbapenem-resistant enterobacterales (cre)
cre infections
cre risk factors
carbapenemase genes.
title Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
title_full Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
title_fullStr Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
title_full_unstemmed Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
title_short Risk factors for Carbapenem-resistant Enterobacterales infections: A case-control study
title_sort risk factors for carbapenem resistant enterobacterales infections a case control study
topic carbapenem-resistant enterobacteriaceae (cre)
carbapenem-resistant enterobacterales (cre)
cre infections
cre risk factors
carbapenemase genes.
url https://safpj.co.za/index.php/safpj/article/view/6029
work_keys_str_mv AT sibongakonkembele riskfactorsforcarbapenemresistantenterobacteralesinfectionsacasecontrolstudy
AT sandeepdvasaikar riskfactorsforcarbapenemresistantenterobacteralesinfectionsacasecontrolstudy