Risk Factors Associated with Colonization of Intestine by Carbapenem Resistant Enterobacteriaceae in a Pediatric ICU

Authors : Sonal SAXENA, Suresh KUMAR, Virender KUMAR, Ravinder KAUR

Pages : 75-81

Doi:10.5799/jmid.748690

View : 138 | Download : 275

Publication Date : 2020-11-29

Article Type : Research Paper

Abstract :Objectives: Asymptomatic colonization of the gastrointestinal tract by Carbapenem Resistant Enterobacteriaceae insert ignore into journalissuearticles values(CRE); constitutes a reservoir for transmission that may remain unidentified in hospitals that do not implement active surveillance testing. Aim: To assess the magnitude of colonization of carbapenem resistant Enterobacteriaceae and to analyze various risk factors associated with this colonization in children admitted in PICU. Methods: Three-hundred patients admitted to Pediatric Intensive Care Unit insert ignore into journalissuearticles values(ICU); which tested negative for CRE colonization upon admission were studied for colonization of intestine by CRE after two days of stay in ICU. Risk factors were analyzed with respect to CRE colonized and non CRE colonized groups. Results: Thirty-two insert ignore into journalissuearticles values(10.67%); patients were found to be colonized with CRE; Klebsiella pneumoniae being the predominant species followed by Escherichia coli using CDC screening method. Univariate analysis of risk factors revealed acute bronchopneumonia, acute febrile illness, Gullian-Barre syndrome to be significantly associated with colonization with CRE. Also, sepsis, presence of central line, mechanical ventilation, protein energy malnutrition and intake of steroids, Piperacillin-Tazobactam was found to be highly significant insert ignore into journalissuearticles values(p<0.001);. The odds of developing colonization were significantly higher in children with renal and respiratory disease, sepsis and with intake of broad-spectrum antibiotics. Conclusions: Antimicrobial resistance is a huge public health problem in developing countries and these colonized patients can act as reservoirs of multi drug resistant bacteria resulting in untreatable healthcare associated infections. Large scale epidemiological surveillance studies of CRE using affordable phenotypic methods along with stringent infection prevention control strategies are required. J Microbiol Infect Dis 2020; 10insert ignore into journalissuearticles values(2);:75-81.
Keywords : Carbapenem Resistant Enterobacteriaceae, CRE, Colonization, Risk factors

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