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Prevalence of carbapenemase producing Enterobacterales colonization and risk factor of clinical infection

DC Field Value Language
dc.contributor.author김도균-
dc.contributor.author김미나-
dc.contributor.author송영구-
dc.contributor.author이경화-
dc.contributor.author정석훈-
dc.contributor.author한상훈-
dc.contributor.author이은화-
dc.date.accessioned2023-11-28T03:25:19Z-
dc.date.available2023-11-28T03:25:19Z-
dc.date.issued2023-11-
dc.identifier.issn1876-0341-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/196804-
dc.description.abstractBackground: Carbapenemase-producing Enterobacterales (CPE) are global concerns in infection control, and the number of CPE outbreaks in hospitals is increasing despite the strengthening of contact precautions. This study aimed to confirm the prevalence and transition rate of CPE infection from stool surveillance culture and to identify the acquisition pathway of CPE. Methods: This is a longitudinal review of patients with stool surveillance cultures at a tertiary center in Seoul, South Korea, from July 2018 to June 2020. Pulsed-field gel electrophoresis, multi-locus sequence typing, and whole genome sequencing were performed for carbapenemase-producing Klebsiella pneumoniae and Escherichia coli strains. Results: Among 1620 patients who had undergone stool CPE surveillance cultures, only 7.1% of active surveillance at the Emergency Room (ER) and 4.4% of universal surveillance in the Intensive Care Unit (ICU) were stool CPE positive. The transition rates from stool carriers to clinical CPE infections were 29.4% in the ER and 31.3% in the ICU. However, it was significantly high (55.0%) in the initial stool CPE-negative ICU patients. Among the initial stool CPE-positive patients, hypertension (61% vs. 92.3%, P = 0.004), malignancy (28.8% vs. 53.8%, P = 0.027), and mechanical ventilation (25.4% vs. 53.8%, P = 0.011) were significant risk factors for clinical CPE infection. Molecular typing revealed that sequence type (ST) 307 and ST 395 were dominant in K. pneumoniae, and ST 410 was dominant in E. coli isolates. Conclusions: Active surveillance showed a higher detection rate than universal stool CPE screening, and one-third of positive stool CPE specimens ultimately developed subsquent clinical CPE infection. According to the molecular typing of the identified CPE strains, in-hospital spread prevailed over external inflow, and the transition rate to clinical CPE was particularly high in the ICU. Therefore, in order to control CPE propagation, not only active surveillance to block inflow from outside, but also continuous ICU monitoring within the hospital is necessary.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherElsevier-
dc.relation.isPartOfJOURNAL OF INFECTION AND PUBLIC HEALTH-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHBacterial Proteins / genetics-
dc.subject.MESHBacterial Proteins / metabolism-
dc.subject.MESHCommunicable Diseases*-
dc.subject.MESHEnterobacteriaceae Infections* / diagnosis-
dc.subject.MESHEnterobacteriaceae Infections* / epidemiology-
dc.subject.MESHEscherichia coli / genetics-
dc.subject.MESHHumans-
dc.subject.MESHKlebsiella pneumoniae-
dc.subject.MESHMultilocus Sequence Typing-
dc.subject.MESHPrevalence-
dc.subject.MESHRisk Factors-
dc.subject.MESHbeta-Lactamases / genetics-
dc.subject.MESHbeta-Lactamases / metabolism-
dc.titlePrevalence of carbapenemase producing Enterobacterales colonization and risk factor of clinical infection-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Laboratory Medicine (진단검사의학교실)-
dc.contributor.googleauthorKyoung Hwa Lee-
dc.contributor.googleauthorDokyun Kim-
dc.contributor.googleauthorJun Sung Hong-
dc.contributor.googleauthorSoon Young Park-
dc.contributor.googleauthorNan Hyoung Cho-
dc.contributor.googleauthorMi Na Kim-
dc.contributor.googleauthorYun Jung Lee-
dc.contributor.googleauthorYeonji Wi-
dc.contributor.googleauthorEun Hwa Lee-
dc.contributor.googleauthorSang Hoon Han-
dc.contributor.googleauthorSeok Hoon Jeong-
dc.contributor.googleauthorYoung Goo Song-
dc.identifier.doi10.1016/j.jiph.2023.09.010-
dc.contributor.localIdA04891-
dc.contributor.localIdA00441-
dc.contributor.localIdA02037-
dc.contributor.localIdA04620-
dc.contributor.localIdA03619-
dc.contributor.localIdA04286-
dc.relation.journalcodeJ04249-
dc.identifier.eissn1876-035X-
dc.identifier.pmid37837922-
dc.subject.keywordActive surveillance-
dc.subject.keywordCarbapenemase-
dc.subject.keywordStool carrier-
dc.subject.keywordWhole genome sequencing-
dc.contributor.alternativeNameKim, Dokyun-
dc.contributor.affiliatedAuthor김도균-
dc.contributor.affiliatedAuthor김미나-
dc.contributor.affiliatedAuthor송영구-
dc.contributor.affiliatedAuthor이경화-
dc.contributor.affiliatedAuthor정석훈-
dc.contributor.affiliatedAuthor한상훈-
dc.citation.volume16-
dc.citation.number11-
dc.citation.startPage1860-
dc.citation.endPage1869-
dc.identifier.bibliographicCitationJOURNAL OF INFECTION AND PUBLIC HEALTH, Vol.16(11) : 1860-1869, 2023-11-
Appears in Collections:
1. College of Medicine (의과대학) > BioMedical Science Institute (의생명과학부) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers

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