The use of multi-pronged screening strategy to understand the epidemiology of carbapenemase-producing Enterobacteriaceae in Hong Kong: transition from epidemic to endemic setting

Eur J Clin Microbiol Infect Dis. 2021 Sep;40(9):2017-2022. doi: 10.1007/s10096-021-04173-x. Epub 2021 Mar 5.

Abstract

A multi-pronged carbapenemase-producing Enterobacteriaceae (CPE) screening strategy was implemented in Hong Kong West healthcare network. Of 199,192 fecal specimens from 77,194 patients screening from 1 July 2011 to 30 June 2019, the incidence of CPE per 1000 patient admission significantly increased from 0.01 (2012) to 1.9 (2018) (p<0.01). With appropriate infection control measures, the incidence of nosocomial CPE per 1000 CPE colonization day decreased from 22.34 (2014) to 10.65 (2018) (p=0.0094). Exposure to wet market for purchasing raw pork (p=0.007), beef (p=0.017), chicken (p=0.026), and vegetable (p=0.034) for >3 times per week significantly associated with community acquisition of CPE. Strategic CPE control measures should be implemented in both the hospital and the community.

Keywords: Carbapenemase-producing Enterobacteriaceae; Endemicity; Gastrointestinal colonization.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Bacterial Proteins / biosynthesis
  • Carbapenem-Resistant Enterobacteriaceae / enzymology
  • Carbapenem-Resistant Enterobacteriaceae / genetics*
  • Carbapenem-Resistant Enterobacteriaceae / isolation & purification
  • Child
  • Child, Preschool
  • Diagnostic Screening Programs / statistics & numerical data*
  • Endemic Diseases / statistics & numerical data*
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology*
  • Enterobacteriaceae Infections / prevention & control
  • Enterobacteriaceae Infections / transmission
  • Epidemics / prevention & control*
  • Feces / microbiology
  • Female
  • Hong Kong / epidemiology
  • Humans
  • Infant
  • Infection Control
  • Male
  • Middle Aged
  • Young Adult
  • beta-Lactamases / biosynthesis

Substances

  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase