Risk Factors and Molecular Epidemiology of Infections Among Patients with Intestinal Colonization by Carbapenem-Resistant

Backgroud: To investigate the molecular epidemiology of intestinal colonization by carbapenem-resistant Methods: From August 2023 to August 2024, we retrospectively enrolled CRE-positive patients identified through active rectal swab screening at the First Affiliated Hospital of Kunming Medical University and monitored them for subsequent infections. Colonizing and infecting isolates were collected and tested for carbapenem-resistance genes, major virulence genes, capsular serotypes, and were subjected to multilocus sequence typing (MLST). Clinical data were integrated and multivariate logistic regression was performed to identify risk factors associated with secondary infections. Results: Among 8,088 patients who underwent active intestinal CRE screening, the positivity rate was 0.53% (43/8,088). Among patients with colonization, the incidence of secondary infection was 37.2% (16/43). All patients with secondary infections were colonized and infected with Conclusion: Although the intestinal colonization rate of CRE was relatively low, the risk of secondary infection remained substantial. Bacterial genetic traits and host conditions contribute to secondary infections. Establishing surveillance systems based on clinical and molecular epidemiology coupled with intensified screening in high-risk departments may help identify high-risk patients early and enable proactive interventions to reduce CRE-related secondary infections.