Duration of carbapenemase-producing Enterobacteriales carriage among ICU patients in Miami, FL: A retrospective cohort study

Adriana Jimenez, Kristopher Fennie, Luisa Munoz-Price, Boubakari Ibrahimou, Vukosava Pekovic, Lilian M. Abbo, Octavio Martinez, Gemma Rosello, Kathleen Sposato, Yohei Doi, Mary Jo Trepka

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Current recommendations by the Centers for Disease Control and Prevention suggest placing patients with carbapenem-producing Enterobacteriales (CPE) in contact precautions, but there is no consensus on the appropriate duration of precautions. Aim: We aimed to evaluate predictors for prolonged CPE carriage and median clearance time. Methods: Patients with first isolated CPE identified from 2012-2016 were followed for clearance of CPE using at least two rectal or tracheal aspirate surveillance cultures and clinical cultures during intensive-care-unit admission. Predictors associated with prolonged CPE carriage were assessed using Cox proportional-hazards. Results: Out of 75 eligible patients, 25 (33%) cleared their CPE-carrier status; median time to clearance was 80 days (Range, 16-457). Patients who were immunocompromised, had mechanical ventilation exposure, or exposure to carbapenems had 66%, 66%, and 86% (HR, 0.34, 0.34, and 0.14, respectively [P-value <.05]) lower probability of clearing compared to those immunocompetent of without such exposures. Patients with CPE isolated from more than one body site had a 5.3 times higher probability of clearing their CPE-carrier status (P-value <.001). Conclusions: Patients immunocompromised, with mechanical ventilation exposure, or exposure to carbapenems had higher risk for prolonged CPE carriage. Infection prevention programs should consider these predictors as part of their assessment of discontinuing contact precautions among CPE carriers to prevent horizontal transmission and outbreaks within healthcare facilities.

Original languageEnglish (US)
Pages (from-to)1281-1286
Number of pages6
JournalAmerican Journal of Infection Control
Volume49
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • Antimicrobial stewardship
  • Carbapenemase
  • Carrier state
  • Enterobacteriaceae
  • Infection control
  • Patient isolation

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Duration of carbapenemase-producing Enterobacteriales carriage among ICU patients in Miami, FL: A retrospective cohort study'. Together they form a unique fingerprint.

Cite this