Risk factors for OXA-carbapenemase-producing Enterobacterales acquisition in Israel: A retrospective case control...

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Carbapenemase-producing Enterobacterales (CPE) present a significant healthcare challenge, complicating treatment and control efforts.
• Hospital-centered screening approaches are often insufficient for detecting CPE, particularly OXA-producing CPE (OXA-CPE).
• Identifying specific risk factors for CPE acquisition is crucial for developing targeted prevention strategies.

Purpose of the Study:

• To identify independent risk factors associated with the acquisition of CPE in hospitalized adults.
• To specifically investigate risk factors for OXA-CPE compared to other CPE types.
• To inform public health and clinical strategies for CPE prevention.

Main Methods:

• A retrospective case-control study design was employed using data from Clalit Health Services.
• Adult patients hospitalized between 2016 and 2023, screened for CPE, were included.
• Multivariable logistic regression analysis was used to identify independent risk factors, with subgroup analyses for OXA-CPE.

Main Results:

• Significant risk factors for CPE acquisition included chronic ventilation, diabetes, multiple hospitalizations, Arab ethnicity, and recent antibiotic use.
• Subgroup analysis revealed similar risk factors for OXA-CPE and non-OXA-CPE, with a notable exception.
• Arab ethnicity demonstrated a significantly stronger association with OXA-CPE acquisition (OR = 3.36) compared to non-OXA-CPE (OR = 1.39).

Conclusions:

• CPE acquisition is multifactorial, influenced by healthcare exposure and underlying chronic conditions.
• OXA-CPE acquisition presents a unique epidemiological association with Arab ethnicity.
• These findings underscore the need for tailored screening and prevention strategies considering specific ethnic risk factors.