Abstract
BackgroundRapid development and global spread of multidrug resistant Klebsiella pneumonia (K. pneumoniae) as a major cause of nosocomial infections is really remarkable. The aim of this study was to explore risk factors for health care associated blood stream infections (BSI) caused by ESBL-producing K. pneumoniae in children and analyze clinical outcomes.MethodsA retrospective review of patients younger than 18 years-old with blood stream infection caused by K. pneumoniae was performed. Patients with ESBL-producing K. pneumoniae isolates were compared with ESBL-non-producing isolates in terms of risk factors, outcome and mortality.ResultsAmong 111 K. pneumoniae isolates 62% (n = 69) were ESBL –producing K. pneumoniae. The median total length of hospitalization and median length of stay in hospital before infection was significantly higher in patients with ESBL-producing isolates than ESBL-non-producing. Use of combined antimicrobial treatment was significantly different between ESBL-producing and ESBL-non-producing groups, 75.4% and 24.6%, respectively (p = 0.001). Previous aminoglycoside use was higher in cases with ESBL –producing isolates (p = 0.001). Logistic regression analysis showed a significant correlation between mortality and use of combined antibiotics (OR 4.22; p = 0.01).ConclusionESBL production in K. pneumoniae isolates has a significant impact on clinical course of BSIs. Total length of hospitalization, length of hospital stay before infection, prior combined antibiotic use and use of aminoglycosides were significant risk factors for development of ESBL-producing K. pneumoniae related BSI.
Highlights
Rapid development and global spread of multidrug resistant Klebsiella pneumonia (K. pneumoniae) as a major cause of nosocomial infections is really remarkable
A total of 97 pediatric patients with 111 K. pneumoniae isolates were included in the study
No statistically significant differences were found between the groups in terms of gender (p = 0.99), and patients with Extended spectrum β lactamase (ESBL)-producing isolates were younger than ESBL-nonproducers (p = 0.04)
Summary
Rapid development and global spread of multidrug resistant Klebsiella pneumonia (K. pneumoniae) as a major cause of nosocomial infections is really remarkable. The aim of this study was to explore risk factors for health care associated blood stream infections (BSI) caused by ESBL-producing K. pneumoniae in children and analyze clinical outcomes. Significant number of health care associated infections in adults and children are caused by gram-negative microorganisms [1, 2]. During the last ten years, changes in antibiotic susceptibility profiles of gram-negative microorganisms have been studied because there is an increasing prevalence of infections due to ESBL (Extended spectrum β lactamase) producing Klebsiella pneumonia (K. pneumoniae). The objectives of this study were to assess risk factors for health care associated BSI caused by ESBL-producing K. pneumoniae in children, analyze clinical outcomes and compare with ESBL-non-producers
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