Incidence of Carbapenem–resistant Enterobacteriaceae in Suratthani Hospital

Abstract

            Carbapenem–resistant Enterobacteriaceae (CRE) infection in the hospital is a major problem that has a direct impact to patients,health personnel and hospital. The purpose of this retrospective,
descriptive research was to study the incidence rate of CRE and to investigate factors associated with CRE in the hospital. The subjects were patients who were admitted in Suratthani hospital. The data were collected from October, 1 2013 to September, 30 2015. The CRE infection in the hospital data collection form and criterion of infection in Suratthani hospital that was adopted from the Centers for Disease Control and Prevention (CDC), USA (1992 ; 2002) was used to collect the data.The data were analyzed using descriptive statistics, Chi-square test Fisher’s exact test and Mann-Whitney U test.Carbapenem–resistant Enterobacteriaceae (CRE) infection in the hospital is a major problem that has a direct impact to patients,health personnel and hospital. The purpose of this retrospective,
descriptive research was to study the incidence rate of CRE and to investigate factors associated with CRE in the hospital. The subjects were patients who were admitted in Suratthani hospital. The data were collected from October, 1 2013 to September, 30 2015. The CRE infection in the hospital data collection form and criterion of infection in Suratthani hospital that was adopted from the Centers for Disease Control and Prevention (CDC), USA (1992 ; 2002) was used to collect the data.The data were analyzed using descriptive statistics, Chi-square test Fisher’s exact test and Mann-Whitney U testThe results revealed that in 2015 the total of patient days was 281,622 days or 60,961 discharged patients. CRE infection was diagnosed 35 times. The nosocomial infection rate was 0.12 times/1000 patient days and 0.57 times/1000 discharged patient. The majority of the patients’ infections were caused by ventilator-associated pneumonia (34.80%); followed by catheter-related urinary tract infection (30.40%). The most common pathogens were Klebsiella pneumonia (60.70%), Escherichia coli (26.80%) and Enterobacter cloacae (8.93%).The number of patients between 16-59 years and over 60 years were
almost similar (41.80% and 52.70% respectively). Most of the patients did not received antibiotics in the past 3 months. However, most of them have a history of immunocompromised host (92.70%) and received catheter insertion (80.00%). Majority of the patients were admitted in medical ward (46.30%), followed by surgical ward (42.00%). Patients with CRE infection had a higher cost of antibiotic and a longer length of stay than those who were not infected (111,864.00 and 115,23.25 baht; 67.00 and 26.70 days, respectively). Moreover, the length of stay in thehospital of the study group was significantly higher than those in the control group (p <0.05).The results of this study suggested that controlling and preventing CRE infection in medical ward and surgical ward were important and necessary. Especially among patients who were admitted in the hospital for longer than 4 weeks.