Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study
Older patients with multiple comorbidities often necessitate prolonged hospital stays and antibiotic treatment in the intensive care unit (ICU), leading to a rise in multidrug-resistant organisms like carbapenem-resistant <i>Enterobacteriaceae</i> (CRE). This study examined risk factors...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/11/12/2970 |
| _version_ | 1797380015701098496 |
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| author | Jung-Hwan Lee Jongbeom Shin Soo-Hyun Park Boram Cha Ji-Taek Hong Don-Haeng Lee Kye Sook Kwon |
| author_facet | Jung-Hwan Lee Jongbeom Shin Soo-Hyun Park Boram Cha Ji-Taek Hong Don-Haeng Lee Kye Sook Kwon |
| author_sort | Jung-Hwan Lee |
| collection | DOAJ |
| description | Older patients with multiple comorbidities often necessitate prolonged hospital stays and antibiotic treatment in the intensive care unit (ICU), leading to a rise in multidrug-resistant organisms like carbapenem-resistant <i>Enterobacteriaceae</i> (CRE). This study examined risk factors for carbapenem-resistant Enterobacteriaceae colonization in the ICU and assessed probiotics’ preventive role. In this single-center, retrospective study, 9099 ICU patients were tested for stool CRE culture from March 2017 to April 2022. We excluded 136 patients with CRE colonization within one week post-admission and 26 who received probiotics before CRE colonization. Ultimately, 8937 CRE-negative patients were selected. Logistic analysis identified CRE colonization risk factors and evaluated probiotics’ influence, including <i>Saccharomyces boulardii</i> or <i>Lactobacillus rhamnosus</i>, used by 474 patients (5.3%) in the ICU. Compared with data on initial admission, 157 patients (1.7%) had newly discovered CRE colonization before discharge. In a multivariate analysis, coronavirus disease 2019, the ICU, tube feeding, antibiotics such as aminoglycoside, extended-spectrum penicillin, stool vancomycin-resistance <i>enterococci</i> colonization, and chronic kidney disease were significantly associated with de novo CRE infection. However, probiotic use was negatively correlated with CRE infection. Managing risk factors and administering probiotics in the ICU may help prevent CRE colonization; large randomized prospective studies are needed. |
| first_indexed | 2024-03-08T20:31:20Z |
| format | Article |
| id | doaj.art-d871b42c3e2b4b81af4578df0ad952da |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-08T20:31:20Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-d871b42c3e2b4b81af4578df0ad952da2023-12-22T14:26:15ZengMDPI AGMicroorganisms2076-26072023-12-011112297010.3390/microorganisms11122970Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis StudyJung-Hwan Lee0Jongbeom Shin1Soo-Hyun Park2Boram Cha3Ji-Taek Hong4Don-Haeng Lee5Kye Sook Kwon6Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaDepartment of Neurology, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, Republic of KoreaOlder patients with multiple comorbidities often necessitate prolonged hospital stays and antibiotic treatment in the intensive care unit (ICU), leading to a rise in multidrug-resistant organisms like carbapenem-resistant <i>Enterobacteriaceae</i> (CRE). This study examined risk factors for carbapenem-resistant Enterobacteriaceae colonization in the ICU and assessed probiotics’ preventive role. In this single-center, retrospective study, 9099 ICU patients were tested for stool CRE culture from March 2017 to April 2022. We excluded 136 patients with CRE colonization within one week post-admission and 26 who received probiotics before CRE colonization. Ultimately, 8937 CRE-negative patients were selected. Logistic analysis identified CRE colonization risk factors and evaluated probiotics’ influence, including <i>Saccharomyces boulardii</i> or <i>Lactobacillus rhamnosus</i>, used by 474 patients (5.3%) in the ICU. Compared with data on initial admission, 157 patients (1.7%) had newly discovered CRE colonization before discharge. In a multivariate analysis, coronavirus disease 2019, the ICU, tube feeding, antibiotics such as aminoglycoside, extended-spectrum penicillin, stool vancomycin-resistance <i>enterococci</i> colonization, and chronic kidney disease were significantly associated with de novo CRE infection. However, probiotic use was negatively correlated with CRE infection. Managing risk factors and administering probiotics in the ICU may help prevent CRE colonization; large randomized prospective studies are needed.https://www.mdpi.com/2076-2607/11/12/2970probioticsrisk factorcarbapenem-resistant <i>Enterobacteriaceae</i>prevention |
| spellingShingle | Jung-Hwan Lee Jongbeom Shin Soo-Hyun Park Boram Cha Ji-Taek Hong Don-Haeng Lee Kye Sook Kwon Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study Microorganisms probiotics risk factor carbapenem-resistant <i>Enterobacteriaceae</i> prevention |
| title | Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study |
| title_full | Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study |
| title_fullStr | Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study |
| title_full_unstemmed | Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study |
| title_short | Role of Probiotics in Preventing Carbapenem-Resistant <i>Enterobacteriaceae</i> Colonization in the Intensive Care Unit: Risk Factors and Microbiome Analysis Study |
| title_sort | role of probiotics in preventing carbapenem resistant i enterobacteriaceae i colonization in the intensive care unit risk factors and microbiome analysis study |
| topic | probiotics risk factor carbapenem-resistant <i>Enterobacteriaceae</i> prevention |
| url | https://www.mdpi.com/2076-2607/11/12/2970 |
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