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Risk Factors for and Clinical Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Nosocomial Infections: A Retrospective Study in a Tertiary Hospital in Beijing, China
| Content Provider | Scilit |
|---|---|
| Author | Zhang, Huijuan Guo, Zhe Chai, Yan Fang, Yi-Peng Mu, Xiangdong Xiao, Nan Guo, Jun Wang, Zhong |
| Copyright Year | 2021 |
| Description | Journal: Infection and Drug Resistance |
| Abstract | Purpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have been increasingly reported worldwide. We aimed to identify the risk factors for nosocomial CRKP infections and assess the clinical outcomes. Patients and Methods: We conducted a case-control study with data collected from January 2016 to December 2018 in China. Controls were selected at a ratio of 1:1 from patients with nosocomial carbapenem-susceptible Klebsiella pneumonia (CSKP) infections. Risk factors for nosocomial CRKP infections and clinical outcomes were assessed with univariate and multivariate analyses. Results: A total of one hundred forty-two patients with CRKP infections and one hundred forty-two patients with CSKP infections were enrolled in this study. Multivariate analysis showed that exposure to antibiotics within 3 months prior to admission (odds ratio OR, 2.585; 95% confidence interval [CI], 1.425– 4.691; P=0.002), exposure to carbapenems (OR, 2.532; 95% CI, 1.376– 4.660; P=0.003), exposure to fluoroquinolones (OR, 3.309; 95% CI, 1.326– 8.257; P=0.010), and the presence of a nasogastric tube (OR, 2.796; 95% CI, 1.369– 5.712; P=0.005) were independent risk factors for CRKP infections. The 30-day mortality rate in the CRKP group was 19.7%, while the in-hospital mortality rate was 28.9%. In the CRKP group, a higher creatinine level (OR, 1.009; 95% CI, 1.002– 1.016; P = 0.013), being in shock at the time of a positive culture (OR, 4.454; 95% CI, 1.374– 14.443; P = 0.013), and co-infection with other resistant bacteria (OR, 4.799; 95% CI, 1.229– 18.740; P = 0.024) were independent predictors of in-hospital mortality in patients with CRKP infections. Kaplan–Meier curves showed that the CRKP group had a shorter survival time than the CSKP group. Conclusion: Nosocomial CRKP infection was associated with exposure to carbapenems and fluoroquinolones within 3 months prior to hospitalization and the presence of a nasogastric tube. Patients infected with CRKP had higher 30-day and in-hospital mortality rates. A higher creatinine level, shock and co-infection with other resistant bacteria were independent predictors of in-hospital mortality in patients with CRKP infections. |
| Related Links | https://www.dovepress.com/getfile.php?fileID=68443 |
| Ending Page | 1401 |
| Page Count | 9 |
| Starting Page | 1393 |
| ISSN | 11786973 |
| e-ISSN | 11786973 |
| DOI | 10.2147/idr.s298530 |
| Journal | Infection and Drug Resistance |
| Volume Number | ume 14 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2021-04-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Infection and Drug Resistance Carbapenem-resistant Klebsiella Pneumoniae Risk Factors Clinical Outcomes Nosocomial Infection |
| Content Type | Text |
| Subject | Infectious Diseases Pharmacology Pharmacology (medical) |
