Factors Associated with Carbapenem-resistant Escherichia Coli Infection and the Results of Carbapenems Antimicrobial Stewardship Program
The purpose of this study aimed to investigate factors associated with Carbapenemsresistant Escherichia coli (CRE-E.coli) infection and the outcome of Antimicrobial Stewardship Program of carbapenems drug groups among patients at Roi Et Hospital. This study was hospital based Unmatched case-control study. All data were retrieved from medical records of admitted patients at Roi Et Hospital between January 1st, 2017 to December 31st, 2018. The Antimicrobial Stewardship Program (ASP) of carbapenems drug groups was collected data from medical records of patient before and after receives program and collected May 1st, to December 31st, 2017. The statistical analyses were used descriptive statistics, univariate analysis and multivariate analysis by multiple logistic regressions. It shows that of 150 cases with CRE-E.coli infection most of them were male 66.67%, mean age 57.28 years (SD = 16.49), admitted at Intensive care unit 40.91%. And 300 controls were non-CRE-E.coli infection, most of them were male 50.00%, mean age 60.68 years (SD = 16.85). After analysis were found patients underwent with endotracheal tube (ORAdj = 4.37; 95%CI = 2.84-6.71), mechanical ventilator (ORAdj = 1.92; 95%CI =1.28-2.95), and carbamenems used (ORAdj = 3.06; 95%CI = 2.03-4.61) were important risk factors for CRE-E.coli infection. After ASP was found appropriated proportion of medical order was increases from 80.70 % to 93.60 %, changed plan followed pharmacist recommendation 90.01 %, and cost of carbapenems after ASP was decreases 77,000 Baht. In conclusion, this study revealed that patients underwent with invasive medical devices including endotracheal tube, mechanical ventilator and carbapenems used were important risk factors for CRE-E.coli infection. The outcome of ASP by pharmacist recommendation were found the appropriate proportion of carbapenems medical order was increase, doctors has changed plan followed recommendation, and costs of carbapenems used after ASP was decreases.
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