Risk factors and outcomes for carbapenem-resistant klebsiella pneumoniae in hematological patients

Abstract

Background Prolonged hospitalization, prolonged neutropenia, and immunosuppressive treatments increase bloodstream infections in hematological patients. Identifying risk factors for carbapenem-resistant Klebsiella pneumonia (CRKP) infection will shed light on controlling the spread of CRKP. Our retrospective study aimed to determine the clinical features, antimicrobial susceptibility, and mortality risk factors of patients who developed CRKP in patients followed up for hematological cancer in the Izmir University of Economics Haematology Department.
 Material and Methods 19,170 blood-urine-sputum cultures were delivered from the patients, 1,595 (8.31%) of which presented growth. CRKP comprised 302 (1.57%) of such growth cases. The study included 72 patients with hematological malignancy who presented CRKP growth in 302 cultures obtained during the neutropenic fever period.
 Results The mean age of patients was 51 (18-75 years). Acute myeloid leukemia was the most common disease (n: 26, 36.11%). As to the antibiotic sensitivity of CRKP, 44 patients (61.1%) were colistin sensitive, 28 patients (38.9%) were colistin-resistant, 47 patients (65.3%) were tigecycline sensitive/medium sensitivity, 25 patients (34.7%) were tigecycline resistant, there was no statistically significant difference between antibiotic sensitivities and survival.
 Conclusions Today, early detection of CRKP colonization in high-risk hematological patients, taking rectal culture, and if the patient presents rectal colonization of CRKP or had CRKP bacteremia during prior hospitalizations, early initiation of treatment with antibiotics acting against CRKP during NPF would significantly reduce mortality.