Medical science monitor : international medical journal of experimental and clinical research · 2015
Risk factors of carbapenem-resistant Klebsiella pneumoniae infection: a serious threat in ICUs.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Candevir Ulu Aslıhan, Kurtaran Behice, Inal Ayşe Seza, Kömür Süheyla, Kibar Filiz, Yapıcı Çiçekdemir Hatice, Bozkurt Seval, Gürel Derya, Kılıç Fatma, Yaman Akgün, Aksu Hasan Salih Zeki, Taşova Yeşim
Аннотация
BACKGROUND: Nosocomial infections caused by Carbapenem-resistant Klebsiella pneumoniae (CRKP) are increasing. Our aim in this study was to investigate the risk factors of CRKP infections.
MATERIAL/METHODS: A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis.
RESULTS: Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0-93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193-8.819) and OR: 3.590 (1.056-12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754-2.724), nasogastric catheter OR: 3.562 (1.317-9.634), peripheral arterial catheter OR: 2.545 (1.027-6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110-16.842).
CONCLUSIONS: Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs.
MATERIAL/METHODS: A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis.
RESULTS: Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0-93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193-8.819) and OR: 3.590 (1.056-12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754-2.724), nasogastric catheter OR: 3.562 (1.317-9.634), peripheral arterial catheter OR: 2.545 (1.027-6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110-16.842).
CONCLUSIONS: Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overAutomationCarbapenemsChildChild, PreschoolCross InfectionDrug Resistance, BacterialFemaleHumansInfantInfant, NewbornIntensive Care UnitsKlebsiella InfectionsKlebsiella pneumoniaeMaleMiddle AgedMultivariate AnalysisRetrospective StudiesRisk FactorsSoftwareYoung Adult