Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors
Introduction:Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study. Methodology:The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were re...
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The Journal of Infection in Developing Countries
2014-01-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/3091 |
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| author | Murat Dizbay Ozlem Guzel Tunccan Omer Karasahin Firdevs Aktas |
| author_facet | Murat Dizbay Ozlem Guzel Tunccan Omer Karasahin Firdevs Aktas |
| author_sort | Murat Dizbay |
| collection | DOAJ |
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Introduction:Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study.
Methodology:The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed.
Results:A total of 720 patients were included in the study. Carbapenem resistance among Klebsiella spp. were significantly increased between 2003 and 2007 (p<0.001). CRK strains were mostly isolated from ICUs (p<0.001). Use of imipenem and cefoperazone-sulbactam within prior three months, stay in ICU, receiving immunspressive therapy, receiving H2 receptor antagonists, tracheostomy, mechanical ventilation, hemodialysis, urinary catheter were found to be significant risk factors for carbapenem resistance Klebsiella spp. infections. In a multivariate analysis, prior use of imipenem (OR 3.35; CI 1.675-6.726, p<0.001), stay in ICU (OR 3.36; 95% CI 1.193-9.508; p=0.022), receiving H2 receptor antagonist (OR 4.49; 95% CI 1.011-19.951; p=0.048) were independently associated with carbapenem resistance. Respiratory tract infections were the most seen nosocomial infection. Attack mortality rate was significantly higher in patients infected with CRK strains (p<0.001). CRK strains showed significantly higher resistance rates to other antibiotics.
Conclusions:In conclusion, the emergence and rapid spread of CRK strains in our hospital is worrisome. The patients in ICU are most important risk group for the acquisition of CRK strains. High resistant rates to other antibiotics except than colistin and tigecycline limits therapeutic options, and increases mortality rates.
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| format | Article |
| id | doaj-art-9d7b7b2560a9499e97865eac1a9d4ff3 |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-9d7b7b2560a9499e97865eac1a9d4ff32025-08-20T03:52:42ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802014-01-0180110.3855/jidc.3091Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factorsMurat Dizbay0Ozlem Guzel Tunccan1Omer Karasahin2Firdevs Aktas3Gazi University Faculty of MedicineGazi University Faculty of MedicineGazi University Faculty of MedicineGazi University Faculty of Medicine Introduction:Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study. Methodology:The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed. Results:A total of 720 patients were included in the study. Carbapenem resistance among Klebsiella spp. were significantly increased between 2003 and 2007 (p<0.001). CRK strains were mostly isolated from ICUs (p<0.001). Use of imipenem and cefoperazone-sulbactam within prior three months, stay in ICU, receiving immunspressive therapy, receiving H2 receptor antagonists, tracheostomy, mechanical ventilation, hemodialysis, urinary catheter were found to be significant risk factors for carbapenem resistance Klebsiella spp. infections. In a multivariate analysis, prior use of imipenem (OR 3.35; CI 1.675-6.726, p<0.001), stay in ICU (OR 3.36; 95% CI 1.193-9.508; p=0.022), receiving H2 receptor antagonist (OR 4.49; 95% CI 1.011-19.951; p=0.048) were independently associated with carbapenem resistance. Respiratory tract infections were the most seen nosocomial infection. Attack mortality rate was significantly higher in patients infected with CRK strains (p<0.001). CRK strains showed significantly higher resistance rates to other antibiotics. Conclusions:In conclusion, the emergence and rapid spread of CRK strains in our hospital is worrisome. The patients in ICU are most important risk group for the acquisition of CRK strains. High resistant rates to other antibiotics except than colistin and tigecycline limits therapeutic options, and increases mortality rates. https://jidc.org/index.php/journal/article/view/3091Klebsiella sppCarbapenem resistanceRisk factorNosocomial infection |
| spellingShingle | Murat Dizbay Ozlem Guzel Tunccan Omer Karasahin Firdevs Aktas Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors Journal of Infection in Developing Countries Klebsiella spp Carbapenem resistance Risk factor Nosocomial infection |
| title | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
| title_full | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
| title_fullStr | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
| title_full_unstemmed | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
| title_short | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
| title_sort | emergence of carbapenem resistant klebsiella spp infections in a turkish university hospital epidemiology and risk factors |
| topic | Klebsiella spp Carbapenem resistance Risk factor Nosocomial infection |
| url | https://jidc.org/index.php/journal/article/view/3091 |
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