A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients

Hu, Yangmin; Ping, Yanting; Li, Leiqing; Xu, Huimin; Yan, Xiaofeng; Dai, Haibin

doi:10.3855/jidc.6697

Cited by 44 publications

(31 citation statements)

References 29 publications

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“…In our study, previous exposure to carbapenems predisposed patients for HIs caused by CR-Kp by 7.0-fold (95% CI=1.054-46.572; p=0.044) consistent with the results of previous studies (17,18). According to the case-control study by Wu and associates (14), an independent risk factor for contracting CP-Kp infection is the previous use of carbapenems (OR=12.69, 95% CI=2.09-77.10; p=0.006).…”

Section: Discussionsupporting

confidence: 92%

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

Djordjevic

Folić

Gajovic

et al. 2018

Serbian Journal of Experimental and Clinical Research

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Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a major threat to patients in hospitals, increasing mortality, length of stay and costs. e aim of this study was to discover risk factors for the development of hospital infections (HIs) caused by CR-Kp. A prospective cohort study was conducted in the Medical-Surgical Intensive Care Unit of the Clinical Centre in Kragujevac, Kragujevac, Serbia, from January 1, 2011, to December 31, 2015 (OR=1.080; p=0.045); previous use of carbapenems (OR=7.005; p=0.044); previous use of ciprofl oxacin (OR=20.628; p=0.007) and previous use of metronidazole (OR=40.320; p=0.011 p=0.046), dužina primene antibiotske terapije pre nastanka bolničke infekcije (OR=1.080; p=0.045), prethodna upotreba karbapenema (OR=7.005; p=0.044), prethodna upotreba ciprofl oksacina (OR=20.628; p=0.007) i prethodna upotreba metronidazola (OR=40.320; p=0.011

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Section: Discussionsupporting

confidence: 92%

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

Djordjevic

Folić

Gajovic

et al. 2018

Serbian Journal of Experimental and Clinical Research

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“…Although the CRE prevalence in Thailand remains low (<5%), the rate of CRE detection has been rising over time . The increasing rate of CRE in hospitals has been affected by various factors . One important reason for the recent spread and development of antibiotic resistance is antimicrobial consumption.…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…3,6,7 The increasing rate of CRE in hospitals has been affected by various factors. [8][9][10][11][12] One important reason for the recent spread and development of antibiotic resistance is antimicrobial consumption. Numerous studies have demonstrated that an increasing rate of antimicrobial usage is associated with a rising incidence of bacterial resistance.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

Correlation between antimicrobial consumption and the prevalence of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae at a university hospital in Thailand

et al. 2018

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Summary What is Known and Objective Carbapenem‐resistant Enterobacteriaceae (CRE) are virulent gram‐negative bacilli and cause urgent healthcare problems worldwide. One of the main factors leading to the emergence of CRE is antimicrobial consumption. The objective of this study was to assess how closely the rate of antimicrobial consumption and the prevalences of carbapenem‐resistant Escherichia coli (CR‐EC) and carbapenem‐resistant Klebsiella pneumoniae (CR‐KP) are correlated. Methods A retrospective study was performed at a university hospital in Thailand from January 2013 to September 2016. The prevalence of E coli and K pneumoniae was represented as percentages per species per quarter. The antimicrobial consumption rate per quarter was expressed as the defined daily dose (DDD)/1000 patient‐days. Evaluation of the relationships between the rate of antimicrobial consumption and the prevalences of CR‐EC and CR‐KP was conducted via Pearson's or Spearman's correlation analyses. Results and Discussion During the study period, the prevalence of CR‐EC and CR‐KP was less than 6%; however, significantly increasing prevalences were reported for both CR‐EC (r = 0.55, P = 0.03) and CR‐KP (r = 0.87, P < 0.01). There was a significant increasing trend in the consumption of meropenem (r = 0.65, P = 0.01), levofloxacin (r = 0.63, P = 0.01), ceftriaxone (r = 0.55, P = 0.03), ertapenem (r = 0.52, P = 0.05) and the carbapenem group (r = 0.64, P = 0.01). A significant correlation was observed between CR‐KP prevalence and total carbapenem consumption (r = 0.55, P = 0.04). Moreover, levofloxacin consumption had a significant positive relationship with the prevalence of CR‐KP (r = 0.65, P = 0.01). No positive correlation was found with the prevalence of CR‐EC. What is New and Conclusion The rate of consumption of levofloxacin and carbapenems was the important key factor correlated with the rate of emergence of CR‐KP. This is the first report demonstrating the correlation between levofloxacin consumption and CR‐KP prevalence.

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“…The rising incidence of resistant strains may be due to high antibiotic exposure. Antibiotic exposure could be identified as a risk factor for emerging resistance in gram-negative bacteria in other settings [10]. The antibiotic exposure after kidney transplantation is elevated due to treatment of asymptomatic bacteriuria (ASB) and pneumocystis pneumonia (PCP) prophylaxis.…”

Section: Introductionmentioning

confidence: 99%

Increased resistance of gram-negative urinary pathogens after kidney transplantation

et al. 2017

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BackgroundUrinary tract infection is the most common complication after kidney transplantation. It can cause severe sepsis and transplant loss. Emergence of drug resistance among gram-negative urinary pathogens is the current challenge for urinary tract infection treatment after kidney transplantation.MethodsThis study analyzes the antimicrobial susceptibility of gram-negative urinary pathogens after kidney transplantation from 2009 to 2012 at the Transplant Outpatient Clinic of the University Hospital Essen, Germany. Kidney transplant patients at the University Hospital Essen receive regular follow up examinations after transplantation. Midstream urines were examined for bacteriuria at each follow up visit.ResultsFrom 2009 to 2012 15.741 urine samples were obtained from 859 patients. In 2985 (19%) samples bacterial growth was detected. The most frequently detected gram-negative bacteria were E.coli 1109 (37%), Klebsiella spp. 242 (8%) and Pseudomonas aeruginosa 136 (4.5%). Klebsiella spp. showed a significant increase of resistance to trimethoprim-sulfamethoxazole by 19% (p = 0.02), ciprofloxacin by 15% (p = 0.01) and ceftazidime by 17% (p = 0.004). E.coli and P. aeruginosa isolates presented no significant differences of antimicrobial susceptibility to the analyzed antibiotics.ConclusionsAntimicrobial resistance of Klebsiella spp. increased significant to trimethoprim-sulfamethoxazole, ciprofloxacin and ceftazidime from 2009 to 2012.

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A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients

Cited by 44 publications

References 29 publications

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

Correlation between antimicrobial consumption and the prevalence of carbapenem-resistant Escherichia coli and carbapenem-resistant Klebsiella pneumoniae at a university hospital in Thailand

Increased resistance of gram-negative urinary pathogens after kidney transplantation

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