%0 Thesis
%9 Master Essay
%A Bozich, Corrine
%D 2017
%F pittir:31585
%I University of Pittsburgh
%T A case control study of risk factors associated with CRE/CRO and ESBL
%U http://d-scholarship-dev.library.pitt.edu/31585/
%X 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.