3 risk factors for recurrence of CRE carriage

Researchers determined three risk factors for recurrence of carbapenem-resistant Enterobacteriaceae among patients presumed CRE-free in a case-control study published in Infection Control & Hospital Epidemiology.

The study included CRE carriers in whom CRE carriage presumably ended after two screening samples tested negative on separate days. CRE recurrence was identified using clinical samples and repeated rectal screening in subsequent admissions to any healthcare facility in Israel. Patients with CRE recurrence were compared with recurrence-free patients over the duration of one follow-up year.

All total, the study included 276 CRE-free carriers, 36 (13 percent) of whom experienced recurrence of CRE carriage within a year following presumed eradication. When the carrier status was presumed to be eradicated six months after the last known CRE-positive sample, CRE recurrence was 25 percent, compared with 7.5 percent if eradication was presumed after one year.

The three factors strongly associated with CRE recurrence were:

  • The months between the last positive CRE sample and presumed eradication
  • Presence of foreign bodies at the time of presumed eradication; and
  • Recurrent admissions to healthcare facilities during follow-up

The study authors suggest CRE-carrier status be maintained for at least one year following the last positive sample and advise healthcare facilities to screen all prior CRE carriers regardless of their current carriage status.

 

 

More articles on CRE:
CDC applauds Chicago hospitals' technique for fighting CRE infections
Advocate Lutheran General Hospital reports no new cases of CRE since 2013 outbreak
1 CRE infection reported at USC Verdugo Hills Hospital

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