Abstract
The spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) worldwide is a serious problem. This retrospective, matched case–control, parallel study in a tertiary teaching hospital analyzed the microbiological and clinical characteristics of CPKP infection, focusing on the risk factors for carbapenem resistance and patient mortality. The hospital department with the highest incidence of CPKP infections was the intensive care unit. All CPKP strains examined were positive for blakpc-2, and 84.8% of CPKP were ST11. Hypervirulent phenotype was identified in 22.7% of the patients with CPKP, with these strains displaying a high incidence of positivity for entB, ybtS, and iutA. Multivariate conditional logistic regression analysis demonstrated that Pitt bacteremia score >4, prior stomach tube, continuous renal replacement therapy (CRRT), and previous carbapenem exposure were associated with CPKP infection. Higher albumin concentration and use of cephalosporins after diagnosis were strong prognostic factors for crude 28-day mortality. Further, high APACHE II score, CRRT, use of carbapenems after diagnosis, and bacteremia were risk factors for crude in-hospital mortality. CPKP isolates showed clonal spread and were resistant to most antibiotics, resulting in higher financial burden. Critical illness was associated with increased mortality.
Highlights
Klebsiella pneumoniae are normal microbiota that can colonize the upper respiratory tract, gastrointestinal tract, and urinary tract in humans.[1]
This matched retrospective cohort study assessed the incidence, risk factors, antibiotic resistance, and medical costs associated with the acquisition of health care-associated K. pneumoniae infections in patients admitted to the First Affiliated Hospital of Zhejiang University in 2014
Due to the extensive use of antibiotics, the rates of carbapenemase-producing K. pneumoniae (CPKP) infection, even of MDR and XDR strains, are increasing.[4]. This analysis of KPC2-producing K. pneumoniae showed that MDR CPKP was spread by clonal strains, resulting in higher antibiotic costs
Summary
Klebsiella pneumoniae are normal microbiota that can colonize the upper respiratory tract, gastrointestinal tract, and urinary tract in humans.[1]. Increasing rates of hypervirulent K. pneumoniae infections have been reported worldwide.[8]
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