American journal of translational research · 2021
Risk factors for carbapenem-resistant Klebsiella pneumoniae infection and associated clinical outcomes.
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Dai Guanqun, Xu Yanling, Kong Hui, Xie Weiping, Wang Hong
Аннотация
OBJECTIVE: To evaluate the risk factors and clinical outcomes of carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) (CRKP) infection.
MATERIALS AND METHODS: A case-control study was performed from January 2017 to September 2017. The risk factors and clinical outcomes of CRKP cases (n = 91) were compared with those of the controls infected with carbapenem-susceptible K. pneumoniae (CSKP) (n = 91). Antibiotic susceptibility was determined using Etest while the type of bacteria was identified by Vitek 2.
RESULTS: CRKP infection was associated with prior use of carbapenems, β-lactam antibiotics, tigecycline, and hormones; complications with cerebrovascular lesions; chronic obstructive pulmonary disease; as well as prolonged hospitalization. Multivariable analysis showed that the use of carbapenem independently correlates with carbapenem resistance in the multivariable analysis. Carbapenem resistance, mechanical ventilation, tracheotomy, deep vein cannulation, indwelling urinary tract catheter, ICU treatment, and high Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) scores were related to in-hospital mortality.
CONCLUSION: CRKP is a widely spread pathogen associated with high in-hospital mortality. Minimizing the use of antimicrobials, specifically the carbapenems, may be effective to reduce CRKP infection.
MATERIALS AND METHODS: A case-control study was performed from January 2017 to September 2017. The risk factors and clinical outcomes of CRKP cases (n = 91) were compared with those of the controls infected with carbapenem-susceptible K. pneumoniae (CSKP) (n = 91). Antibiotic susceptibility was determined using Etest while the type of bacteria was identified by Vitek 2.
RESULTS: CRKP infection was associated with prior use of carbapenems, β-lactam antibiotics, tigecycline, and hormones; complications with cerebrovascular lesions; chronic obstructive pulmonary disease; as well as prolonged hospitalization. Multivariable analysis showed that the use of carbapenem independently correlates with carbapenem resistance in the multivariable analysis. Carbapenem resistance, mechanical ventilation, tracheotomy, deep vein cannulation, indwelling urinary tract catheter, ICU treatment, and high Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) scores were related to in-hospital mortality.
CONCLUSION: CRKP is a widely spread pathogen associated with high in-hospital mortality. Minimizing the use of antimicrobials, specifically the carbapenems, may be effective to reduce CRKP infection.