Risk Factors for Intra-Abdominal Infections Caused by Carbapenemase-Producing Enterobacteriaceae in a Surgical...

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Surgical Infections

Background:

• Carbapenemase-producing Enterobacteriaceae (CPE) pose a significant threat in healthcare settings.
• Intra-abdominal infections (IAI) caused by CPE are associated with high morbidity and mortality.
• Identifying risk factors for CPE acquisition in surgical patients is essential for targeted prevention strategies.

Purpose of the Study:

• To identify independent risk factors associated with the acquisition of intra-abdominal infections (IAI) caused by carbapenemase-producing Enterobacteriaceae (CPE) in surgical patients.
• To provide data for the development of clinical guidelines for preventing CPE-IAI.
• To stratify surgical patients based on their risk for developing CPE-IAI.

Main Methods:

• A matched case-control study was conducted.
• Cases included patients with CPE-related IAI acquired during general surgery admission (January 2013-December 2018).
• Controls were patients with IAI caused by non-resistant bacteria, matched in a 1:3 ratio. Logistic regression was used to identify independent risk factors.

Main Results:

• Forty patients with IAI-CPE were matched with 120 controls.
• Independent risk factors for IAI-CPE acquisition included previous hospitalization (OR 2.56), digestive endoscopy (OR 4.11), carbapenem therapy (OR 9.54), and aminoglycoside use (OR 45.41).
• These four factors were significant predictors (p < 0.05) of CPE-IAI acquisition.

Conclusions:

• Previous hospitalization, digestive endoscopy, carbapenem therapy, and aminoglycoside use are significant risk factors for acquiring CPE-IAI in surgical patients.
• These findings can help clinicians identify high-risk patients.
• Targeted interventions for these risk factors may reduce the incidence of CPE-IAI.