RT Journal Article
SR Electronic
T1 Trends in community- and nosocomial-acquired infections of carbapenem resistant Enterobacteriaceae (CRE), carbapenemase producing Enterobacteriaceae (CPE) and vancomycin resistant Enterococcus (VRE): a 10-year prospective observational study
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 2021.02.22.432249
DO 10.1101/2021.02.22.432249
A1 Gloria Maritza Ubillus Arriola
A1 William Araujo Banchon
A1 Lilian Patiño Gabriel
A1 Lenka Kolevic
A1 María del Carmen Quispe Manco
A1 José María Olivo Lopez
A1 Armando Barrientos Achata
A1 Maria Elena Revilla Velasquez
A1 Donia Bouzid
A1 Enrique Casalino
YR 2021
UL http://biorxiv.org/content/early/2021/02/22/2021.02.22.432249.abstract
AB Introduction CRE, CPE, and VRE are considered significant threats to public health.Aim To determine trends of nosocomial- and community-acquired infections.Methods A 10-year prospective observational non-interventional study was conducted. We used time-series analysis to evaluate trends in infections number.Findings Infection rate (%) were: CRE 2.48 (261/10,533), CPE 1.66 (175/10,533) and VRE 15.9 (121/761). We found diminishing trends for CRE (−19% [−31;−5], P=.03) and CPE (−22% [−30;−8], P=.04) but increasing trend for VRE (+48; [CI95% 34;75], P=.001). While we found decreasing trends for CRE and CPE in emergency (−71 [−122;−25], P=.001; −45 [−92;−27], P=.001) and hospitalization (−127 [−159; −85], P=.001; −56 [−98;−216], P=.01), we found increasing trends for VRE (+148 [113;192], P=.00001; +108[65;152], P=.003). Nosocomial-infections fell in CRE (−238 [−183;−316], P=.0001) and CPE (−163 [−96; −208], P=.001), but rose in VRE (+196 [151;242], P=.0001). We showed increasing trends in ambulatory and community-acquired infections in CRE (+134% [96;189]; P=.001; +77% [52;89]; P= .002), CPE (+288 [226;343]; P=.0001; +21% [−12;46]; P=.0.08) and VRE (+348 [295;458]; P=.0001; +66% [41;83]; P=.003). Direct admitted trends rose in all groups (CRE 16% [−8; 42]; P=.05), CPE 23% [−6; 48] (P=.05) and VRE (+241 [188; 301]; P=.0001).Conclusions We found a changing infection pattern with decreasing trends in in-hospital settings and nosocomial-acquired infections but increasing ambulatory and community-acquired infections. The observed increasing-trends in direct-admitted could be explained by community-onset infections diagnosed in the hospital. Our findings highlight the need to identify CRE/CPE/VRE community-acquired infections in ambulatory and in-hospital settings.