| Objectives In order to explore whether screening of anal swabs can be used as an effective screening method for carbapenem-resistant Enterobacteriaceae infection;The difference of 30-day mortality between CRE infection and non-CRE infection was compared,and the correlation between the length of stay in ICU and the detection rate of CRE was evaluated.Methods Routine anal swabs were screened for all ICU patients who met the inclusion criteria for 5 consecutive months from July 2018 to November 2018.Anal swabs were collected once on the day of admission,3 days and 7 days respectively,and the corresponding clinical data(such as laboratory results,examination reports,clinical manifestations,vital signs,clinical diagnostic results,etc.)were recorded.Subsequently,the above data were analyzed by SPSS version 21.0.Results According to the inclusion criteria,a total of 102 patients were screened with anal swabs during 5 month.31 patients were found to be CRE positive,21 of them were screened by anal swabs,23 patients were clinically diagnosed as CRE infection and 8 were colonized.Then Kappa test and Ncnemar paired chi-square test were used to check.The results showed that the Kappa value was 0.595,the P value was less than 0.001,and the Ncnemar value was 0.791.Screening of anal swabs was significantly consistent with carbapenem-resistant Enterobacteriaceae infection,and the results were statistically significant.Subsequently,102 patients were followed up for 30 days.The results showed that infected patients with CRE had a higher mortality rate than those non-CRE infected patients(43.5% VS 15.2%),and the log-rank P value < 0.05,there was statistical significance.According to the length of stay in ICU,85 patients,who admitted to ICU more than 48 hours,were divided into two groups.The first groud was <7 days group and 43 patients were enrolled,in which 5(11.6%)patients were found to be CRE positive,while the second group was ≥7 days group and 42 patients were enrolled,in which 18(42.9%)were found to be CRE positive.The results showed that the CRE in ≥7 days group was nearly four times higher than that in <7 days group,with chi-square value=10.499 and P value=0.001,and the difference was statistically significant.Spearman rank correlation test was used to test the data of two groups.Statistical analysis showed that R = 0.351,P value = 0.001 had significant difference.It proved that the length of ICU hospitalization time was positively correlated with the CRE infection.If we further ranked the number of days for the first detection of CRE after ICU admission,we found that most of the time for the first detection of CRE after ICU admission is within 7 days(10/102,9.8%).Conclusions Carbapenem-resistant Enterobacteriaceae infection will prolong hospitalization,the time of ICU stay,mortality and other adverse consequences.Anal swab can be used as an screening method for carbapenem-resistant Enterobacteriaceae infection and colonization in our hospital,which can help us effectively prevent and control nosocomial infection,guide diagnosis and treatment,and improve the quality of medical treatment and prognosis of patients.ICU,a high incidence area of nosocomial infection,and long hospital stay in ICU is more common to prone CRE detection.Figure 3;Table 10;Reference 76... |
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