Determination of carbapenemase-producing enterobacteriaceae colonization by rectal swabs and causative risk factors in patient hospitalized in intensive care units

The rapid spread of carbapenemase-producing enterobacteriaceae (CPE) strains worldwide is accepted as an immediate threat to human health. Being carried in a hosting gastrointestinal system, CPE spreads easily in healthcare institutions and its spreading can be reduced by identifying the risk factors affecting colonization development and taking the appropriate measures. This thesis aims at investigating the prevalence of CPE in the ICUs of our hospital and the risk factors affecting CPE development. The study included 39 patients with CPE colonization and 126 patients without CPE colonization who were under treatment in the ICUs of anesthesiology and reanimation and internal medicine departments of Gaziantep University Medical School between 10 January 2017 and 30 March 2017. During the study period of two and a half months, CPE colonization was detected in 39 patients (23.6%). While 58.9% (23) of the patients already had colonization at the time of hospitalization, 41.02% (16) had colonization afterwards and the colonization of patients was found to develop in 16±10.8 days. The risk factors including a history of hospitalization before ICU, use of carbapenem in the past 90 days, the APACHI II score and intubation, which were found significant in the development of CPE colonization in the single-variable analysis, were reassessed with the logistik regression analiysis. Presence of hospitalization before ICU was found to increase the CPE colonization risk 3.914 fold, parenteral feeding 5,589 fold, use of tracheostomy 14.927 fold, use of NG tubes 3.278 fold, and a previous history of carbapenem use 4,83 fold. Eleven (6.6%) of the 39 colonized patients were infected with CPE and 26 (66.7%) of the 39 patients in the CPE group were ex during treatment. In conclusion, with an active surveillance of 2.5 months in the ICUs of our hospital, CPE colonization was detected at a rate of 23.6%, which is higher than the world and Turkey averages. Considering CPE as a national problem, each hospital should set out an early detection protocol and infection control measures according to their own patient characteristics, risk factors and surveillance results. Keywords: Carbapenemase-producing Enterobacteriaceae, Colonization, Risk Factors.