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

OXA-producing carbapenemase-producing Enterobacterales (OXA-CPE) are challenging hospital-centered screening approaches. This study aimed to identify risk-factors for CPE acquisition, focusing on OXA-CPE.

A retrospective case-control study was conducted using data from Clalit Health Services. Adults (≥ 20 years) hospitalized between 2016 and 2023 and screened for CPE were included. Cases were defined as first-time CPE-positive. Each case was matched 1:1 to a hospitalized control from the same hospital, department, and admission date. Exposure data included comorbidities, hospitalizations, outpatient clinic visits, recent antibiotic use, and socioeconomic status. Multivariable logistic regression identified independent risk factors for CPE acquisition. Subgroup analysis compared risk-factors for OXA-CPE versus non-OXA-CPE.

Among 96,306 screened patients, 1,609 CPE-positive cases were matched to controls. Median age was comparable in CPE cases and controls (70.5 vs 69 years respectively). Significant CPE risk factors included chronic ventilation (OR = 3.16), diabetes (OR = 1.33), multiple hospitalizations (OR > 3.9), Arab ethnicity (OR = 2.07), and recent antibiotic use (OR = 1.96). In subgroup analysis, risk-factors were similar between OXA and non-OXA groups, except for Arab ethnicity, which had a stronger association with OXA-CPE (OR = 3.36 vs 1.39, interaction P = .0059). No interaction was found for other variables.

CPE acquisition is linked to health care exposure and chronic illness, but OXA-CPE shows a unique association with Arab ethnicity.