OBJECTIVE To explore the epidemiological characteristics and risk factors of carbapenem-resistant Enterobacteriaceae (CRE) infections in elderly inpatients, and to provide evidence for hospital-associated infection prevention and control and antimicrobial agent management.

METHODS A retrospective case-control study was conducted, selecting 158 elderly inpatients diagnosed with CRE infections at Taihe Hospital affiliated to Hubei University of Medicine from Jan. 2014 to Dec. 2024 as the study objects, and 158 elderly patients admitted during the same period without CRE infections were selected as the control group at a ratio of 1∶1. Clinical data, including demographic characteristics, underlying diseases, antimicrobial agent usage, invasive procedures, infection sites and antimicrobial resistance patterns, were collected from both groups. Multivariate conditional logistic regression models were used to analyze the risk factors for CRE infections.

RESULTS The 158 elderly inpatients with CRE infections were mainly concentrated in cerebrovascular and cardiovascular departments, with Klebsiella pneumoniae as the predominant pathogen. CRE strains generally exhibited resistance rates exceeding 70% to broad-spectrum antimicrobial agents like cephalosporins, but were relatively sensitive to tigecycline and polymyxin B. Multivariate logistic regression analysis revealed that hypoproteinemia (OR=3.876), puncture procedures (OR=2.832), endotracheal intubation (OR=3.391), human albumin infusion (OR=5.853), blood transfusion (OR=3.788), use of glycopeptide antimicrobial agents (OR=10.533) and indwelling urinary catheter (OR=2.208) were risk factors for CRE infections (P < 0.05).

CONCLUSIONS In elderly inpatients, CRE infections primarily affect the respiratory system, with K. pneumoniae as the predominant pathogen. Hypoproteinemia, invasive procedures and the use of glycopeptide antimicrobial agents are identified as risk factors.