Korean J healthc assoc Infect Control Prev.  2022 Dec;27(2):162-167. 10.14192/kjicp.2022.27.2.162.

Outbreaks of Carbapenem Resistant Enterobacterales (CRE) According to the Type of Hospitals

• Yun SJ
• Kwon SM
• Hur ES
• Park SJ
• Lee YH
• Pyeon HS
• Jeong IH

• KMID: 2537077
• DOI: http://doi.org/10.14192/kjicp.2022.27.2.162

Abstract

Background
Carbapenem-resistant Enterobacterales(CRE) are increasing rapidly worldwide, posing a major threat to global health. This study aimed to identify the epidemiological characteristics of CRE isolated in Gyeonggi-do according to hospital type.
Methods
We conducted antibiotic susceptibility and genetic tests for carbapenemase-producing Enterobacterales (CPE) among 1,243 clinical isolates of CRE from Gyeonggi-do in 2019. CRE strains were identified using MALDI-TOF (Microflex, BRUKER, Germany), and antimicrobial susceptibility tests were performed using the broth microdilution method, according to the CLSI guidelines. Genetic testing of the CPE type was performed for KPC, NDM, OXA-48, IMP, VIM, and GES.
Results
Most CRE infections in Gyeonggi-do occurred in general hospitals (60.9%) and long-term care hospitals (27.8%). While the proportion of the CPE group in general hospitals was low (55.7%), 85.0% of CRE isolates in long-term care hospitals were identified in the CPE group. In the CPE group, the proportion of CRE isolates above the minimum inhibitory concentration of carbapenem namely meropenem, imipenem, and doripenem was 76.0%, 90.2%, and 66.5%, respectively. The non-CPE group showed a relatively low resistance percentage (44.6% [meropenem], 27.6% [imipenem], and 25.2% [doripenem]) compared to the CPE group. Furthermore, we found a correlation between CPE genes and carbapenem resistance rate on the Kruskal–Wallis test (P≤0.05).
Conclusion
Carbapenem resistance rate and the genetic characteristics of CRE isolates differed according to the type of hospital in which they occurred. The high proportion of the CPE group in long-term care hospitals indicates the need for more attention to strict infection control in these hospitals.

Keyword

Carbapenem-resistant Enterobacterales; Carbapenemase-producing Enterobacterales; Long-term care hospital; General hospital

Figure

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  Fig. 1 Outbreaks of CRE according to the type of hospitals.

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