NDLI: Influence of antibiotic pressure on multi-drug resistant Klebsiella pneumoniae colonisation in critically ill patients

Content Provider	Springer Nature : BioMed Central
Author	Ruiz, Jesus Gordon, Monica Villarreal, Esther Frasquet, Juan Sánchez, María Ángeles Martín, María Castellanos, Álvaro Ramirez, Paula
Abstract	Background The aim of this study is to evaluate the risk factors for colonisation by multidrug resistant (MDR) K. pneumoniae in a critical care unit and the relationship between colonisation and the antibiotic pressure exerted by the antimicrobial treatments received by patients. Methods A prospective observational was designed. Patients admitted for more than 48 h to an intensive care unit were included. Samples for surveillance cultures were obtained from all the patients upon admission and once a week. The association between risk factors and colonisation by MDR K. pneumoniae was determined by logistic regression. A Cox regression model was used to evaluate the effect of the use of antimicrobials on the colonisation rate. An ARMIA model was used to investigate the association between the incidence of colonisation by MDR strains and the global consumption of antimicrobials in the unit. Results One thousand seven hundred twenty-five patients were included, from which 308 (17.9%) were positive for MDR K. pneumoniae. In the multivariate analysis, hospitalisation for longer than 7 days together with respiratory infection and administration of any antibiotic was associated with increased MR K. pneumoniae colonisation. Patients who received antibiotics for more than 48 h were colonised earlier than patients who did not receive antibiotic treatment [HR: 2.16 (95%CI:1.55–3.03)]. The ARIMA model found a significant association between the monthly colonisation rate for MR K. pneumoniae and the consumption of cephalosporins and carbapenems in the previous month. Conclusion Individual antibiotic administration and the global antibiotic pressure of cephalosporins and carbapenems are associated to an increased colonisation by MDR K. pneumoniae strains.
Related Links	https://aricjournal.biomedcentral.com/counter/pdf/10.1186/s13756-019-0484-8.pdf
Ending Page	7
Page Count	7
Starting Page	1
File Format	HTM / HTML
ISSN	20472994
DOI	10.1186/s13756-019-0484-8
Journal	Antimicrobial Resistance & Infection Control
Issue Number	1
Volume Number	8
Language	English
Publisher	BioMed Central
Publisher Date	2019-02-14
Access Restriction	Open
Subject Keyword	Medical Microbiology Drug Resistance Infectious Diseases K pneumoniae Antibiotic Critcal care Multidrug resistance Colonization
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Infectious Diseases Microbiology (medical) Pharmacology (medical)
Journal Impact Factor	4.8/2023
5-Year Journal Impact Factor	5.8/2023

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