Clinical Significance of Stool Screening for Carbapenem-resistant Enterobacteriaceae in Hospitalized Aged Patients Transferred from other Hospitals in Japan

Abstract

Futoshi Kawaura, Takuya Kishi, Ayako Takamori, Kohei Yamanouchi, Tomohiro Imamura, Naomi Ko-bayashi-Watanabe, Ayako Matsuo, Kuniyasu Takagi, Tsukuru Umemura, Yoshitaka Hirooka and Shinichiro Hayashi

Elderly patients transferred from other hospitals or nursing homes may have multiple underlying diseases and were often treat- ed with antimicrobial agents. We aimed to detect CRE carriers by screening stool specimens from elderly patients over 65 who were transferred from other hospitals. A stool sample was collected from all the 2,201 patients aged older than 65 years old who were transferred to the Takagi hospital from other hospitals or nursing homes between July 9, 2017, and May 31, 2021. The rate of the carbapenem-resistant Enterobacteriaceae (CRE) carriers in the stool samples were 1.2%, and CRE-positive patients (n=26) had higher pulse rates and poorer performance status than CRE-negative patients (n=78). They had more extended hos- pital stays and more antibiotic use prior to admission. Gastrointestinal diseases were the most common cause of hospitalization. In multivariate analysis, more CRE-positive patients were hospitalized for antibiotic use and digestive diseases. In conclusion, patients with a history of antibiotic use and those hospitalized for digestive diseases are at higher risk of testing positive for CRE. CRE-positive patients were also suggested to be in poorer condition and to have a more extended hospital stay.

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