Ertapenem resistance in 2 tertiary-care hospitals: Microbiology, epidemiology, and risk factors

Enferm Infecc Microbiol Clin. 2017 Oct;35(8):511-515. doi: 10.1016/j.eimc.2015.11.009. Epub 2016 Jan 6.
[Article in English, Spanish]

Abstract

Introduction: Carbapenems resistance is a growing phenomenon and a threat to public health because of the reduced therapeutic options for resistant infections.

Methods: A retrospective case-control study was conducted in 2 tertiary-care hospitals in Medellín, Colombia. Fifty patients infected with ertapenem-resistant enterobacteriaceae were compared with a control group consisting of 100 patients with infections caused by ertapenem susceptible enterobacteriaceae. A multivariate logistic regression model was used to identify factors that best explain ertapenem-resistant enterobacteriaceae infections.

Results: The factors associated with ertapenem-resistant enterobacteriaceae infections were prior exposure to carbapenems (adjusted OR 3.43; 95% IC 1.08-10.87) and prior exposure to cefepime (adjusted OR 6.46; 95% IC 1.08-38.38).

Conclusion: Prior exposure to antibiotics is the factor that best explains the ertapenem-resistant enterobacteriaceae infection in this population, highlighting the importance of antimicrobial stewardship programs in hospitals.

Keywords: Carbapenem resistance; Carbapenems; Carbapenémicos; Enterobacteriaceae infections; Factores de riesgo; Infecciones por Enterobacteriaceae; Resistencia a carbapenémicos; Risk factors.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Antimicrobial Stewardship
  • Carbapenems / therapeutic use
  • Case-Control Studies
  • Cefepime / therapeutic use
  • Colombia / epidemiology
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology*
  • Diagnosis-Related Groups
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / isolation & purification
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / epidemiology
  • Enterobacteriaceae Infections / microbiology*
  • Ertapenem / pharmacology*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Tertiary Care Centers / statistics & numerical data*
  • beta-Lactam Resistance*

Substances

  • Carbapenems
  • Cefepime
  • Ertapenem