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A case control study of risk factors associated with CRE/CRO and ESBL

Bozich, Corrine (2017) A case control study of risk factors associated with CRE/CRO and ESBL. Master Essay, University of Pittsburgh.

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Abstract

Antibiotic resistance is a growing problem that affects public health. Antibiotic resistance is prominent at large medical centers with complicated medical care and need for prolonged use of broad spectrum antibiotics. Multi-drug resistant Gram negative rods (GNR-MDRO) are a group of bacteria that pose a particular threat, as they cause life-threatening infections with limited options for treatment. This is a case-control study that aims at answering questions regarding MDRO origin and risk factors. We are including in this study three types of MDRO; Extended-spectrum β-lactamases (ESBL) (used as the control), Carbapenem-Resistant Enterobactericiae (CRE) and other Carbapenem-Resistant Organisms (CRO) such as lactose non-ferments (mostly Pseudomonas and Acinetobacter). Factors such as indwelling urinary or intravenous catheter upon admission, tracheostomy/ventilator, and chronic wound were found to be significant in a univariate analysis, however, only chronic wound presence (OR: 5.58; 95% CI: 1.87-16.63) and history of tracheostomy/ventilator (OR: 27.06; 95% CI: 3.20-229.15) were significant after entry into a multivariable logistic regression model, meaning that the presence of a chronic wound and/or history of tracheostomy/ventilator is associated with MDRO colonization, specifically CRE/CRO. Hospitals should practice extra care with patients with a chronic wound and/or with a history of a tracheostomy or being on a mechanical ventilator. These patients should be screened for CRE/CRO both upon admission and during their hospital stay in order to provide optimal prevention of CRE colonization and spread.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bozich, Corrinecnb31@pitt.eduCNB31
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairMartinson, Jeremyjmartins@pitt.edujmartinsUNSPECIFIED
Committee MemberHaggerty, CatherineHaggertyC@edc.pitt.eduhaggertyUNSPECIFIED
Committee MemberYassin, Mohamedyassinm@upmc.eduMHY8UNSPECIFIED
Date: 1 April 2017
Date Type: Submission
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Date Deposited: 13 Jul 2017 19:35
Last Modified: 02 Nov 2017 14:00
URI: http://d-scholarship.pitt.edu/id/eprint/31585

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