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Author (up) Meng, X.; Liu, S.; Duan, J.; Huang, X.; Zhou, P.; Xiong, X.; Gong, R.; Zhang, Y.; Liu, Y.; Fu, C.; Li, C.; Wu, A. url  doi
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  Title Risk factors and medical costs for healthcare-associated carbapenem-resistant Escherichia coli infection among hospitalized patients in a Chinese teaching hospital Type Journal Article
  Year 2017 Publication BMC Infectious Diseases Abbreviated Journal BMC Infect Dis  
  Volume 17 Issue 1 Pages 82  
  Keywords Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents/economics/therapeutic use; Anti-Infective Agents; *Carbapenems; Case-Control Studies; Catheterization, Central Venous/statistics & numerical data; Child; Child, Preschool; China/epidemiology; Cross Infection/drug therapy/economics/*epidemiology/microbiology; Drug Costs; *Drug Resistance, Bacterial; Escherichia coli Infections/drug therapy/economics/*epidemiology/microbiology; Female; Health Care Costs; Hemoglobins; Hospitals, Teaching; Humans; Hyperglycemia/epidemiology; Incidence; Infant; Infant, Newborn; Length of Stay/*statistics & numerical data; Logistic Models; Male; Middle Aged; Multivariate Analysis; Retrospective Studies; Risk Factors; Tertiary Care Centers; Tracheostomy/statistics & numerical data; Urologic Diseases/epidemiology; Young Adult; Crec; Csec; Healthcare-associated infection; Risk factors  
  Abstract BACKGROUND: The emergence and spread of Carbapenem-resistant Escherichia coli (CREC) is becoming a serious problem in Chinese hospitals, however, the data on this is scarce. Therefore, we investigate the risk factors for healthcare-associated CREC infection and study the incidence, antibiotic resistance and medical costs of CREC infections in our hospital. METHODS: We conducted a retrospective, matched case-control-control, parallel study in a tertiary teaching hospital. Patients admitted between January 2012 and December 2015 were included in this study. For patients with healthcare-associated CREC infection, two matched subject groups were created; one group with healthcare-associated CSEC infection and the other group without infection. RESULTS: Multivariate conditional logistic regression analysis demonstrated that prior hospital stay (<6 months) (OR:3.96; 95%CI:1.26-12.42), tracheostomy (OR:2.24; 95%CI: 1.14-4.38), central venous catheter insertion (OR: 8.15; 95%CI: 2.31-28.72), carbapenem exposure (OR: 12.02; 95%CI: 1.52-95.4), urinary system disease (OR: 16.69; 95%CI: 3.01-89.76), low hemoglobin (OR: 2.83; 95%CI: 1.46-5.50), and high blood glucose are associated (OR: 7.01; 95%CI: 1.89-26.02) with CREC infection. Total costs (p = 0.00), medical examination costs (p = 0.00), medical test costs (p = 0.00), total drug costs (p = 0.00) and ant-infective drug costs (p = 0.00) for the CREC group were significantly higher than those for the no infection group. Medical examination costs (p = 0.03), total drug costs (p = 0.03), and anti-infective drug costs (p = 0.01) for the CREC group were significantly higher than for the CSEC group. Mortality in CREC group was significantly higher than the CSEC group (p = 0.01) and no infection group (p = 0.01). CONCLUSION: Many factors were discovered for acquisition of healthcare-associated CREC infection. CREC isolates were resistant to most antibiotics, and had some association with high financial burden and increased mortality.  
  Address Infection Control Centre, Xiangya Hospital of Central South University, Changsha, China. xywuanhua@csu.edu.cn  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1471-2334 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:28095785 Approved no  
  Call Number ref @ user @ Serial 99123  
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