PLoS ONE (Jan 2022)

The importance of active surveillance of carbapenem-resistant Enterobacterales (CRE) in colonization rates in critically ill patients.

  • Mabel Duarte Alves Gomides,
  • Astrídia Marília de Souza Fontes,
  • Amanda Oliveira Soares Monteiro Silveira,
  • Daniel Chadud Matoso,
  • Anderson Luiz Ferreira,
  • Geraldo Sadoyama

DOI
https://doi.org/10.1371/journal.pone.0262554
Journal volume & issue
Vol. 17, no. 1
p. e0262554

Abstract

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ObjectiveThis study aimed to demonstrate the importance of active carbapenem-resistant Enterobacterales (CRE) surveillance and evaluate the prevalence of invasive infections, risk factors, and mortality risk in CRE-colonized patients.MethodsRetrospective cohort study analyzing 1,920 patients identified using an active CRE surveillance protocol, admitted to an adult intensive care unit in southeastern Brazil from January 2014 to December 2018.ResultsThere were 297 (15.47%) CRE colonized patients, with one colonized for every six control patients. CRE-colonized patients demonstrated an increased chance of infection (odds ratio [OR] 7.967, p ConclusionsEarly detection of CRE colonization through screening testing proved to be an important tool to control CRE spread. However, observation over the years has shown no effective control of colonization and infection. The prevalence rates of CRE colonization and colonization-infection were high, as were the mortality rates. In conclusion, an active CRE surveillance protocol is essential, but its impact depends on the effective implementation of preventive measures and feedback between team members.