Abstract
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. 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. 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. 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.
Highlights
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is increasingly being reported worldwide [1,2,3,4,5]. These strains are difficult to control because they spread within and between hospitals [6], and treatment options for CRKP infections are extremely limited [7]. These resistant strains are the source of hospitalacquired infections in severely ill patients, and CRKP was independently associated with death or a longer length of stay in the unit when patients with CRKP infection were compared to those infected with carbapenem-susceptible Klebsiella pneumoniae (CSKP) or those without these strains [8,9]
CRKP infection in the intensive care unit (ICU), and an equal number for controls was selected from the ICU
Summary
Carbapenem-resistant Klebsiella pneumoniae (CRKP) is rapidly emerging as a life-threatening nosocomial infection. We aim to identify risk factors, especially antibiotic use, for CRKP infection among intensive care unit (ICU) patients. Carbapenem-resistant Klebsiella pneumoniae (CRKP) is increasingly being reported worldwide [1,2,3,4,5] These strains are difficult to control because they spread within and between hospitals [6], and treatment options for CRKP infections are extremely limited [7]. These resistant strains are the source of hospitalacquired infections in severely ill patients, and CRKP was independently associated with death or a longer length of stay in the unit when patients with CRKP infection were compared to those infected with CSKP or those without these strains [8,9]. We conducted a retrospective study to identify potential risk factors for the isolation of CRKP infection in the ICU, with an emphasis on elucidating the role of antibiotics
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