Risk factors for the acquisition of carbapenem-resistant Escherichia coli at a tertiary care center in South Korea: A matched case-control study

摘要

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.