A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients

  • Yangmin Hu Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Yanting Ping Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Leiqing Li Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Huimin Xu Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Xiaofeng Yan Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
  • Haibin Dai Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

Abstract

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. In this study, we aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients.

Methodology: This was a matched case-control study of a 67-bed ICU in a tertiary care teaching hospital from 1 January 2011 through 30 June 2013. The control cases were selected among the patients with carbapenem-susceptible Klebsiella pneumoniae (CSKP) and were matched with CRKP cases for year of ICU admission and site of infection. The clinical outcomes and antibiotic treatments were analyzed.

Results: One hundred and thirty patients were included in the study (65 cases and 65 controls). Bivariable analysis showed that age of patients (p = 0.044), number of antibiotic groups (p = 0.001), and exposure to carbapenems (p < 0.001) were associated with CRKP infection. Using multivariate analysis adjusted for age, prior hospitalization, number of antibiotic groups, and previous exposure to carbapenems, previous carbapenem exposure (p < 0.001) was identified as an independent risk factor for CRKP infection.

Conclusions: These data suggest that exposure to carbapenems is an independent risk factor for CRKP infection. Patients with this clinical factor should be targeted for interventions to reduce the subsequent risk of infection.
Published
2016-03-31
How to Cite
Hu Y, Ping Y, Li L, Xu H, Yan X, Dai H (2016) A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients. The Journal Of Infection In Developing Countries 10 (03): 208-213. https://doi.org/10.3855/jidc.6697
Section
Original Articles

Keywords

antibiotics; risk factors; multidrug resistance; carbapenem; Klebsiella pneumoniae