原创力文档risk factors, molecular epidemiology and outcomes of ertapenem-resistant, carbapenem-susceptible enterobacteriaceae a case-case-control study风险因素、分子流行病学和结果ertapenem-resistant,carbapenem-susceptible肠杆菌科case-case-control研究.pdfVIP
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risk factors, molecular epidemiology and outcomes of ertapenem-resistant, carbapenem-susceptible enterobacteriaceae a case-case-control study风险因素、分子流行病学和结果ertapenem-resistant,carbapenem-susceptible肠杆菌科case-case-control研究
Risk Factors, Molecular Epidemiology and Outcomes of
Ertapenem-Resistant, Carbapenem-Susceptible
Enterobacteriaceae: A Case-Case-Control Study
1 1 1 1 2 3
Jocelyn Teo , Yiying Cai , Sarah Tang , Winnie Lee , Thean Yen Tan , Thuan Tong Tan , Andrea Lay-
Hoon Kwa1*
1 Department of Pharmacy, Singapore General Hospital, Singapore, Singapore, 2 Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore,
3 Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore
Abstract
Background: Increasing prevalence of ertapenem-resistant, carbapenem-susceptible Enterobacteriaceae (ERE) in Singapore
presents a major therapeutic problem. Our objective was to determine risk factors associated with the acquisition of ERE in
hospitalized patients; to assess associated patient outcomes; and to describe the molecular characteristics of ERE.
Methods: A retrospective case-case-control study was conducted in 2009 at a tertiary care hospital. Hospitalized patients
with ERE and those with ertapenem-sensitive Enterobacteriaceae (ESE) were compared with a common control group
consisting of patients with no prior gram-negative infections. Risk factors analyzed included demographics; co-morbidities;
instrumentation and antibiotic exposures. Two parallel multivariate logistic regression models were performed to identify
independent variables associated with ERE and ESE acquisition respectively. Clinical outcomes were compared between ERE
and ESE patients.
Results: Twenty-nine ERE cases, 29 ESE cases and 87 controls were analyzed. Multivariate logistic regression showed that
previous hospitalization (Odds ratio [OR], 10.40; 95% confidence interval [CI], 2.19–49.20) and duration of fluoroquinolones
exposure (OR
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