Risk Factors of Carbapenem-Resistant Bacteria Infection in Stroke Patients at Sakon Nakhon Hospital : ปัจจัยเสี่ยงต่อการติดเชื้อแบคทีเรียดื้อยาคาร์บาพีเนม ในผู้ป่วยโรคหลอดเลือดสมอง โรงพยาบาลสกลนคร

Abstract

          This unmatched case-control study aimed to determine the risk factors associated with carbapenem-resistant Enterobacteriaceae (CRE) and/or carbapenem-resistant Acinetobacter baumannii (CRAB) in stroke patients admitted in stroke unit of Sakon Nakhon hospital. The case group was stroke patients infected with CRE and/or CRAB while the control group was stroke patients without CRE and/or CRAB infection, 60 patients in each group. The data were collected from the patient records and database of microbiology laboratory, Sakon Nakhon hospital from April 1^st, 2016 to December 31^st, 2018. Baseline data were analyzed using descriptive statistics. The inferential statistics, logistic regression, were applied to analyse the association between the independent variables and the CRE and/or CRAB infection. A p-value of 0.05 was considered significance.

          The results revealed that in the case group, 28 patients were CRE infection (46.70%) and 32 patients were CRAB infection (53.30%). The CRE and/or CRAB infections were mostly caused by ventilator-associated pneumonia (76.60%); followed by catheter-related urinary tract infection (20%). The risk factors of CRE and/or CRAB infection in patients were the previous antibiotic uses (OR_adj= 3.3; 95%CI = 1.2-9.1), the hospitalization more than twenty days (OR_adj= 2.6; 95%CI = 1.1-6.2), endotracheal tubes insertion (OR_adj= 9.8; 95%CI = 1.3-75.5) and nasogastric tube intubation (OR_adj= 9.3; 95%CI = 1.2-74.5). Thus the stroke patients with those risk factors should be provided intensive nursing guidelines and care to prevent and control CRE and/or CRAB infection.

          Keywords : stroke patients, CRE, CRAB, risk factors