잠시만 기다려 주세요. 로딩중입니다.

Positivity of Carbapenemase-producing Enterobacteriaceae in Patients Following Exposure within Long-term Care Facilities in Seoul, Korea

Journal of Korean Medical Science 2020년 35권 36호 p.303 ~ 303
박진주, 서유빈, 이야곱, 엄중식, 송원근, 최영균, 김성란, 손희정, 조난형,
소속 상세정보
박진주 ( Park Jin-Ju ) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Internal Medicine
서유빈 ( Seo Yu-Bin ) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Internal Medicine
이야곱 ( Lee Jacob ) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Internal Medicine
엄중식 ( Eom Joong-Sik ) - Gachon University College of Medicine Gil Medical Center Department of Internal Medicine
송원근 ( Song Won-Keun ) - Hallym University College of Medicine Kangnam Sacred Heart Hospital Department of Laboratory Medicine
최영균 ( Choi Young-Kyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Critical Care Medicine
김성란 ( Kim Sung-Ran ) - Korea University Guro Hospital Department of Infection Control
손희정 ( Son Hee-Jung ) - Ewha Womens University Mokdong Hospital Department of Infection Control
조난형 ( Cho Nan-Hyoung ) - Gangnam Severance Hospital Department of Infection Control

Abstract


Background: Carbapenemase-producing Enterobacteriaceae (CPE) are emerging as a worldwide threat. Long-term care facilities (LTCFs) are considered a reservoir for CPE and play a central role in transmission to acute care hospitals. We investigated the CPE positivity in patients exposed to CPE in LTCFs. Furthermore, we analyzed the CPE positivity rates in the environment exposed to CPE.

Methods: We collected rectal swab specimens from patients residing in LTCFs who were exposed to CPE. Environmental sampling was performed by infection control practitioners from sites classified as patient private space, common space in the patient room, common space other than patient rooms, and nursing station. Each sample was cultured on a Chrom Klebsiella pneumoniae carbapenemase (KPC) agar for CPE screening. The positive isolates were subjected to a polymerase chain reaction to identify the presence of blaKPC, blaVIM, blaIMP, blaOXA-48, and blaNDM and determine CPE genotype.

Results: From 65 index cases, a total of 24 hospitals and 481 patients were enrolled; 414 patients who had resided in the same patient room as a patient with confirmed CPE and 67 patients who were newly admitted to that patient room. A total of 117 (24.3%) patients were positive for CPE among which 93 (22.5%, 93/414) were already admitted patients and 24 (35.8%, 24/67) were newly admitted patients. A total of 163 CPEs were detected and K. pneumoniae (n = 104, 63.8%) was the most common bacteria followed by Escherichia coli (n = 43, 26.4%) and Citrobacter koseri (n = 11, 6.7%). Environmental sampling was performed in 24 hospitals and 604 sites. A total of 12 sites (2.0%) were positive for CPE and sink in the nursing station (n = 6, 4.2%) was the most contaminated space.

Conclusion: CPE colonization rates in patients exposed to CPE in LTCFs were higher than those found in acute care hospitals. Proper infection control measures for detecting and reducing CPE colonization in patients residing in LTCFs are required. Newly admitted patients could also be carriers; therefore, infection control for newly admitted patients also needs to be thorough.

키워드

Carbapenemase-producing Enterobacteriaceae; Long-term Care Facility; Infection Control

원문 및 링크아웃 정보

 

등재저널 정보