Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: a matched case-control study
Abstract
BACKGROUND
Carbapenem resistance among gram-negative bacilli is an emerging threat worldwide. The objective of this study was to identify risk factors for the acquisition of carbapenem-resistant Escherichia coli (CRE).
METHODS
We conducted a matched case-control study comprising 57 cases of acquisition of CRE and 114 controls (1:2 matched) selected from patients with a culture of carbapenem-susceptible E coli between January 2006 and December 2010 at a 2000-bed tertiary care center in South Korea.
RESULTS
On univariate analysis, previous use of carbapenem (P < .01), fluoroquinolone (P < .01), and glycopeptide (P < .01), as well as length of hospital stay (P < .05), were significantly associated with CRE acquisition. On multivariate analysis, previous use of carbapenem (odds ratio [OR], 4.56; 95% confidence interval [CI] 1.44-14.46; P = .01) and previous use of fluoroquinolone (OR, 2.81; 95% CI, 1.14-6.99; P = .03) were independent risk factors.
CONCLUSIONS
At this institute, the antibiotic selective pressure of carbapenems and fluoroquinolones was shown to be an important risk factor for the acquisition of CRE.
How strong is the evidence?
Evidence Hub reads this as a case-control. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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