The purpose of this study is to identify the factors related to the infection and/or colonization of carbapenemase-producing Enterobacterales (CPE) based on clinical and microbiological data for patients in the intensive care unit (ICU). All patients admitted to medical ICU were screened for CPE on admission and weekly, and this 1:2 case–control study included patients with CPE identified by screening or clinical cultures from 2017 to 2018. The clonal relatedness was evaluated by pulsed-field gel electrophoresis (PFGE). A total of 45 CPE patients were identified with a prevalence of 3.8%. The most frequent organism was Klebsiella pneumoniae (69%) and the carbapenemases belonged to the class A Klebsiella pneumoniae Carbapenemase (KPC-2) (87%), class B New Delhi Metallo-β-lactamase (NDM) (11%), and Imipenemase (IMP-1) (2%) strains. The PFGE profiles showed two large clustered groups of KPC-2-producing K. pneumoniae. In the multivariate analysis, pneumonia/chronic pulmonary disease, previous fluoroquinolone use, and previous use of nasogastric tube were the significant risk factors for CPE infection or colonization in ICU-admitted patients. Critical illness and underlying medical conditions such as pneumonia/chronic pulmonary disease, antimicrobial selective pressure, and the use of a medical device are identified as risk factors for CPE infection or colonization in ICU. Person to person transmission also contributed.

中文翻译：

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在韩国的重症监护病房中产生碳青霉烯酶的肠杆菌感染或定植的危险因素：病例对照研究

这项研究的目的是根据重症监护病房（ICU）患者的临床和微生物学数据，确定与产生碳青霉烯酶的肠杆菌（CPE）的感染和/或定殖有关的因素。所有入院ICU的患者均在入院时和每周进行CPE筛查，该1：2病例对照研究包括2017年至2018年通过筛查或临床培养鉴定出的CPE患者。通过脉冲场凝胶电泳评估了克隆相关性（PFGE）。总共鉴定出45名CPE患者，患病率为3.8％。最常见的生物是肺炎克雷伯菌（69％），碳青霉烯酶属于A类肺炎克雷伯菌碳青霉烯酶（KPC-2）（87％），B类新德里金属-β-内酰胺酶（NDM）（11％）和亚胺培南酶（IMP-1）（2％）菌株。PFGE谱显示出KPC-2产肺炎克雷伯菌的两个大簇群。在多变量分析中，肺炎/慢性肺部疾病，先前使用氟喹诺酮和先前使用鼻胃管是允许ICU入院的患者CPE感染或定植的重要危险因素。重大疾病和潜在的医疗状况（如肺炎/慢性肺部疾病，抗菌药物选择性压力以及使用医疗器械）被确定为CPE感染或在ICU定植的危险因素。人与人之间的传播也有所贡献。