Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units
Introduction: Carbapenemase-producing Enterobacterales (CPE) have emerged as a substantial cause of morbi-mortality worldwide, with a prevalence of approximately 5% in areas with high endemicity. However, available data may not be representative of developing countries, such as Ecuador. In this stu...
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The Journal of Infection in Developing Countries
2021-04-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/13319 |
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| author | Carmen Soria-Segarra Claudia Soria-Segarra Angel Catagua-González Marcia Apolo-Matamoros Franklin Vega-Franco Miguel Chung-Sang César Narváez-Peñaloza Raquel Quijano-Grunauer José Gutiérrez-Fernández |
| author_facet | Carmen Soria-Segarra Claudia Soria-Segarra Angel Catagua-González Marcia Apolo-Matamoros Franklin Vega-Franco Miguel Chung-Sang César Narváez-Peñaloza Raquel Quijano-Grunauer José Gutiérrez-Fernández |
| author_sort | Carmen Soria-Segarra |
| collection | DOAJ |
| description |
Introduction: Carbapenemase-producing Enterobacterales (CPE) have emerged as a substantial cause of morbi-mortality worldwide, with a prevalence of approximately 5% in areas with high endemicity. However, available data may not be representative of developing countries, such as Ecuador. In this study, the incidence of CPE in Ecuador and risk factors for infection/colonisation were evaluated.
Methodology: A prospective cohort study was performed from February to April 2016 in seven intensive-care units of Guayaquil, Ecuador. Samples were processed according to the Centers for Disease Control and Prevention laboratory protocol and the CHROMagar mSuper CARBA agar method. Resistance to carbapenems was defined according to Clinical and Laboratory Standards Institute breakpoints. A modified carbapenemase inactivation method was used to identify carbapenamase production phenotypically with molecular confirmation by multiplex polymerase chain reaction.
Results: In total, 640 patients were enrolled. The incidence of CPE was 36.4% (N = 233). A multivariate analysis indicated that several factors were associated with CPE acquisition, included a long intensive care unit stay (OR 1.05; 95% CI 1.03–1.08; p < 0.01), tracheostomy (OR 3.52; 95% CI 1.90–6.75; p < 0.01), hospitalisation 3 months prior to admission (OR 2.07; 95% CI 1.17–3.71; p < 0.01), vancomycin use (OR 3.31; 95% CI 2.02–5.18; p < 0.01), and macrolide use (OR 3.31; 95% CI 1.43–7.76; p < 0.01).
Conclusions: Macrolide use was a risk factor for CPE acquisition. This association should be evaluated further, especially in developing countries.
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| format | Article |
| id | doaj-art-dff221f870ff4c28bb1d8fd481abeded |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | The Journal of Infection in Developing Countries |
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| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-dff221f870ff4c28bb1d8fd481abeded2025-08-20T02:16:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802021-04-01150410.3855/jidc.13319Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care unitsCarmen Soria-Segarra0Claudia Soria-Segarra1Angel Catagua-González2Marcia Apolo-Matamoros3Franklin Vega-Franco4Miguel Chung-Sang5César Narváez-Peñaloza6Raquel Quijano-Grunauer7José Gutiérrez-Fernández8Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica Santiago de Guayaquil. Guayaquil, EcuadorInstituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica Santiago de Guayaquil. Guayaquil, EcuadorSociedad Ecuatoriana de Estadística. Quito, EcuadorUniversidad de Especialidades Espíritu Santo. Samborondón, EcuadorInstituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica Santiago de Guayaquil. Guayaquil, EcuadorInstituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica Santiago de Guayaquil. Guayaquil, EcuadorInstituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica Santiago de Guayaquil. Guayaquil, EcuadorHospital Abel Gilbert Pontón. Guayaquil, EcuadorDepartment of Microbiology, School of Medicine and PhD Program in Clinical Medicine and Public Health, University of Granada-ibs. Granada, España Introduction: Carbapenemase-producing Enterobacterales (CPE) have emerged as a substantial cause of morbi-mortality worldwide, with a prevalence of approximately 5% in areas with high endemicity. However, available data may not be representative of developing countries, such as Ecuador. In this study, the incidence of CPE in Ecuador and risk factors for infection/colonisation were evaluated. Methodology: A prospective cohort study was performed from February to April 2016 in seven intensive-care units of Guayaquil, Ecuador. Samples were processed according to the Centers for Disease Control and Prevention laboratory protocol and the CHROMagar mSuper CARBA agar method. Resistance to carbapenems was defined according to Clinical and Laboratory Standards Institute breakpoints. A modified carbapenemase inactivation method was used to identify carbapenamase production phenotypically with molecular confirmation by multiplex polymerase chain reaction. Results: In total, 640 patients were enrolled. The incidence of CPE was 36.4% (N = 233). A multivariate analysis indicated that several factors were associated with CPE acquisition, included a long intensive care unit stay (OR 1.05; 95% CI 1.03–1.08; p < 0.01), tracheostomy (OR 3.52; 95% CI 1.90–6.75; p < 0.01), hospitalisation 3 months prior to admission (OR 2.07; 95% CI 1.17–3.71; p < 0.01), vancomycin use (OR 3.31; 95% CI 2.02–5.18; p < 0.01), and macrolide use (OR 3.31; 95% CI 1.43–7.76; p < 0.01). Conclusions: Macrolide use was a risk factor for CPE acquisition. This association should be evaluated further, especially in developing countries. https://jidc.org/index.php/journal/article/view/13319CarbapenemaseEnterobacteralesrisk factorsintensive care unit |
| spellingShingle | Carmen Soria-Segarra Claudia Soria-Segarra Angel Catagua-González Marcia Apolo-Matamoros Franklin Vega-Franco Miguel Chung-Sang César Narváez-Peñaloza Raquel Quijano-Grunauer José Gutiérrez-Fernández Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units Journal of Infection in Developing Countries Carbapenemase Enterobacterales risk factors intensive care unit |
| title | Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units |
| title_full | Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units |
| title_fullStr | Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units |
| title_full_unstemmed | Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units |
| title_short | Macrolides: a novel risk factor for carbapenemase-producing Enterobacterales in intensive care units |
| title_sort | macrolides a novel risk factor for carbapenemase producing enterobacterales in intensive care units |
| topic | Carbapenemase Enterobacterales risk factors intensive care unit |
| url | https://jidc.org/index.php/journal/article/view/13319 |
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