{"id":29197,"date":"2025-10-29T04:08:00","date_gmt":"2025-10-28T20:08:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29197"},"modified":"2025-10-29T05:42:53","modified_gmt":"2025-10-28T21:42:53","slug":"clin-infect-dis%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%99%ae%e9%80%9a%e5%86%85%e7%a7%91%e7%97%85%e6%88%bf%e4%b8%ad%e9%92%88%e5%af%b9%e8%80%90%e7%a2%b3%e9%9d%92%e9%9c%89%e7%83%af%e8%82%a0","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29197","title":{"rendered":"[Clin Infect Dis\u53d1\u8868\u8bba\u6587]\uff1a\u666e\u901a\u5185\u79d1\u75c5\u623f\u4e2d\u9488\u5bf9\u8010\u78b3\u9752\u9709\u70ef\u80a0\u6746\u83cc\u7684\u5f3a\u5316\u9884\u9632\u7b56\u7565"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">Cluster-randomized Controlled Trial of Enhanced Carbapenem-resistant Enterobacterales Prevention Program in General Medicine Wards, Siriraj Hospital<\/h1>\n\n\n\n<h3 class=\"wp-block-heading\">Apiradee Taweesuk,\u00a0Pinyo Rattanaumpawan,\u00a0Siriporn Rachakhom, et al<\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Clin Infect Dis ciaf523,\u00a0<a href=\"https:\/\/doi.org\/10.1093\/cid\/ciaf523\">https:\/\/doi.org\/10.1093\/cid\/ciaf523<\/a><\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Published: 22 September 2025<\/h3>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"533189210\">Abstract<\/h2>\n\n\n\n<p>Background<\/p>\n\n\n\n<p>Carbapenem-resistant Enterobacterales (CRE) colonization is a major risk factor for infection. Most Infection Prevention and Control (IPC) strategies rely on private-room isolation, but evidence of their effectiveness in resource-limited settings is scarce.<\/p>\n\n\n\n<p>Methods<\/p>\n\n\n\n<p>From February-October 2021, we conducted a cluster-randomized controlled trial in six general medical wards at Siriraj Hospital, enrolling adults with \u22651 CRE risk factor. Wards were randomized to standard IPC (sIC) or an enhanced CRE prevention program (eIC) comprising sIC plus monthly staff education, real-time notifications of CRE acquisition, and contact-precaution reminders. Active stool\/rectal CRE surveillance was performed at enrollment and weekly. Primary outcomes were the CRE acquisition incidence and CRE acquisition-free time.<\/p>\n\n\n\n<p>Results<\/p>\n\n\n\n<p>A total of 363 patients were included: 174 in the intervention group (1,684 patient-days) and 189 in the control group (1,517 patient-days). The cumulative incidence of CRE acquisition was slightly lower in the intervention group (36.8% vs. 46.6%; p=<em>0.06<\/em>), with a significantly lower incidence rate per patient-day (0.038 vs. 0.058;<em>p=0.007<\/em>). In a post-hoc analysis excluding acquisitions within 24 hours, the cumulative incidence was similar between groups (25.7% vs. 33.6%;\u00a0<em>p=0.16<\/em>). The probability of remaining CRE-free showed an unadjusted hazard ratio (HR) of 0.72 [95%CI:0.52\u20131.00;<em>p=0.05<\/em>]. After adjusting for prior antibiotic use, the adjusted HR was 0.75 [95%CI:0.54\u20131.05;<em>p=0.09<\/em>]. There were no differences in all-cause mortality or length of hospital stay.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/oup.silverchair-cdn.com\/oup\/backfile\/Content_public\/Journal\/cid\/PAP\/10.1093_cid_ciaf523\/1\/ciaf523_ga.jpeg?Expires=1761689494&amp;Signature=18Jrx9p8AR2ckLb4j1I9SkE5Cj6egaObnqwe5p4bsgxqdNG67co05My3ejGL13foKSswT0ibeidbJpdmD7j-XTPQkHwLnReMNDwDd-3lFXO4eo4e742PLtgzgYer-KcKmyJJAv-wWwz1pF25Bs0KLzwUke7BE9tRBq~PGXdEtfWVzYCxJE2epZV9X5XHqZdKt7Axyfx~LxK4yGPxST2SQVAj7aRnP342ZUa6cG0mLxp0JQoMFUtUyxJgSG--cQVDtEYuvyiRKQGdEwQd4US7HqxT55sNPrNBaDAvzDgXSrxMd32KLxTErgkMPRG7kr4Hy7XwOP~STGMHA6uVOqtkFQ__&amp;Key-Pair-Id=APKAIE5G5CRDK6RD3PGA\" alt=\"\"\/><\/figure>\n\n\n\n<p>Conclusions<\/p>\n\n\n\n<p>CRE acquisition incidence was high in this setting. The enhanced CRE prevention program tended to reduce CRE acquisition and prolong CRE-free survival. Larger studies are needed to explore benefits on morbidity and mortality.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cluster-randomized Controlled Trial of Enhanced Carbape [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29197"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29197"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29197\/revisions"}],"predecessor-version":[{"id":29198,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29197\/revisions\/29198"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29197"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29197"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29197"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}