Summary
Background
To reduce transmission of carbapenemase-producing carbapenem-resistant Enterobacterales
(CP-CRE), screening is recommended for patients sharing rooms with CP-CRE-detected
patients and healthcare workers caring for them.
Aim
The aim of this study was to investigate the transmission rate of CP-CRE among exposed
people in a tertiary hospital using whole-genome sequencing.
Methods
This study was conducted in a 1751-bed tertiary teaching hospital from January 2017
to December 2019. Index patients were defined as those with positive results in CP-CRE
tests during hospitalization. When an index patient was detected in a shared room,
we performed CRE screening tests for patients whose stay overlapped with an index
patient's stay for at least one day. Where a second case was found, healthcare worker
contacts were also screened. CP-CRE were confirmed, and the carbapenemase type identified,
by PCR. Whole-genome sequencing was used to compare isolates from index and exposed
patients.
Results
During the study period, 47 index patients were identified, and they had been in contact
with 152 patients in shared rooms and 54 healthcare workers. None of the healthcare
workers had CRE. Among the 152 exposed patients, four patients had the same type of
carbapenemases as their CP-CRE index patients and all of them were KPC. Whole-genome
sequencing revealed that three of these four pairs showed genotypic accordance between
the index and the exposed.
Conclusion
The CP-CRE transmission rate among the exposed patients was calculated as 2.0% (=
3/152).
Keywords
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Article info
Publication history
Published online: March 17, 2022
Accepted:
March 7,
2022
Received:
December 11,
2021
Identification
Copyright
© 2022 Published by Elsevier Ltd on behalf of The Healthcare Infection Society.
