住院患者CRE检出情况及其阳性危险因素分析

打开文本图片集

Analysis of CRE Detection and Positive Risk Factors in Hospitalized Patients/ ， ，， .//Medical Innovation of China，2025，22（24）：160-163

[Abstract]Objective：To investigate the associated risk factors and clinical characteristics of carbapenemresistant Enterobacteriaceae （CRE）detection among hospitalized patients，and to analyze the epidemiological distribution ofcarbapenemase types in CRE strains，providing evidence for hospital infectioncontrol and rational use of antibiotics.Method： A retrospective survey was conducted on 214 inpatients admited to Ji'an Central People's Hospital from January 2O22 to May 2024.The patients were stratified into control group （n=139）and study group （n=75）basedon the detection statusof CRE during hospitalization.Bacterial identification and antimicrobial susceptibility testing were performed using the DL-96A system. The type of carbapenemase produced by the strain was detected by the carbapenemase inhibitor enhancement test PBA-EDTA methodand PCR.Collect patients'clinical data and perform univariateand multivariatelogisticregresion analyses to identify independent risk factors for CRE detection.Result：Among the 75 patients with CRE detected，KPC-producing strains were predominant [50.67% （38/75）]， followed by NDM-producing strains [28.00% （21/75）] and OXA-48-producing strains [8.00 % （6/75）]， with co-expression of multiple carbapenemase enzymes observed in some isolates. Univariate and multivariate analyses revealed that hospitalization for ⩾14 d，ICU admission， use of third-generation or higher cephalosporins，carbapenems，quinolones，mechanical ventilation，central venous catheters placement，and indwelling urinary catheters were all independent risk factors for CRE detection （ P <0.05）. Conclusion： The primary resistance mechanisms of CRE among hospitalized patients are the production of KPC and NDM carbapenemases. Extended hospitalization，ICU treatment，broad-spectrum antibioticuse，and invasive proceduresare significant risk factors for CRE detection.Strengthening screening in high-risk populations，standardizing antibiotic use，and managing invasive procedures are crucial for reducing the risk of CRE infections.

[Keywords] Carbapenem-resistant Enterobacteriaceae Hospitalized patients Carbapenemase

Antimicrobialstewardship

First-author'saddress：DepartmentofClinicalLaboratory，Ji'anCentral People'sHospital，Ji'an 343000， China

doi：10.3969/j.issn.1674-4985.2025.24.037

耐碳青霉烯类肠杆菌（CRE）是目前医院感染防控中面临的主要耐药病原之一，主要包括肺炎克雷伯菌、大肠埃希菌等[。（剩余4483字）