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Risk factors for carbapenem-resistant Klebsiella pneumoniae infection/colonization and predictors of mortality: a retrospective study.
Pathog Glob Health. 2015 Mar; 109(2):68-74.PG

Abstract

OBJECTIVE

To identify risk factors associated with carbapenem-resistant Klebsiella pneumoniae (CRKP) infection/colonization and death and to investigate the resistance and homology of CRKP.

METHODS

A retrospective 1:1 case-control study was conducted at Changhai Hospital, China, from January 2010 to December 2011.The study population included 30 patients with CRKP infection/colonization and 30 matched patients with carbapenem-susceptible K. pneumoniae (CSKP) infection/colonization at the same site. Homology analysis was conducted by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Potential resistance genes were detected by PCR.

RESULTS

Independent risk factors for CRKP infection/colonization were admission to exposure to glycopeptides [Odds ratio (OR): 43.84, 95% confidence interval (CI): 1.73-1111.91, P = 0.020], cefoperazone plus sulbactam (OR: 49.56, 95% CI: 1.42-1726.72, P = 0.030) and tracheostomy (OR: 677.82, 95% CI: 2.76-1667, P = 0.020). Age (OR: 1.07, 95% CI: 1.00-1.14, P = 0.04), renal dysfunction (OR: 17.63, 95% CI: 2.34-132.87, P = 0.005) and exposure to cefoperazone plus sulbactam (OR: 8.87, 95% CI: 1.29-61.07, P = 0.026) were independent risk factors for the death of patients with K. pneumoniae infection/colonization. Older age (OR: 1.16, 95% CI: 1.01-1.39, P = 0.011) was an independent risk factor for the death of patients with CRKP infection/colonization. Thirty CRKP strains were all KPC-2-producing resistant strains with genotype of ST-11.

CONCLUSION

Exposure to glycopeptides, cefoperazone plus sulbactam and tracheostomy were independent risk factors for CRKP infection/colonization, and older age was an independent risk factor for CRKP infection/colonization caused death.

Authors

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Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25707874

Citation

Jiao, Yang, et al. "Risk Factors for Carbapenem-resistant Klebsiella Pneumoniae Infection/colonization and Predictors of Mortality: a Retrospective Study." Pathogens and Global Health, vol. 109, no. 2, 2015, pp. 68-74.
Jiao Y, Qin Y, Liu J, et al. Risk factors for carbapenem-resistant Klebsiella pneumoniae infection/colonization and predictors of mortality: a retrospective study. Pathog Glob Health. 2015;109(2):68-74.
Jiao, Y., Qin, Y., Liu, J., Li, Q., Dong, Y., Shang, Y., Huang, Y., & Liu, R. (2015). Risk factors for carbapenem-resistant Klebsiella pneumoniae infection/colonization and predictors of mortality: a retrospective study. Pathogens and Global Health, 109(2), 68-74. https://doi.org/10.1179/2047773215Y.0000000004
Jiao Y, et al. Risk Factors for Carbapenem-resistant Klebsiella Pneumoniae Infection/colonization and Predictors of Mortality: a Retrospective Study. Pathog Glob Health. 2015;109(2):68-74. PubMed PMID: 25707874.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for carbapenem-resistant Klebsiella pneumoniae infection/colonization and predictors of mortality: a retrospective study. AU - Jiao,Yang, AU - Qin,Yanghua, AU - Liu,Jiajun, AU - Li,Qiang, AU - Dong,Yuchao, AU - Shang,Yan, AU - Huang,Yi, AU - Liu,Rui, Y1 - 2015/02/24/ PY - 2015/2/25/entrez PY - 2015/2/25/pubmed PY - 2016/1/27/medline KW - Antimicrobial resistance KW - Carbapenem-resistant Klebsiella pneumoniae, KW - Mortality, KW - Risk factors, SP - 68 EP - 74 JF - Pathogens and global health JO - Pathog Glob Health VL - 109 IS - 2 N2 - OBJECTIVE: To identify risk factors associated with carbapenem-resistant Klebsiella pneumoniae (CRKP) infection/colonization and death and to investigate the resistance and homology of CRKP. METHODS: A retrospective 1:1 case-control study was conducted at Changhai Hospital, China, from January 2010 to December 2011.The study population included 30 patients with CRKP infection/colonization and 30 matched patients with carbapenem-susceptible K. pneumoniae (CSKP) infection/colonization at the same site. Homology analysis was conducted by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). Potential resistance genes were detected by PCR. RESULTS: Independent risk factors for CRKP infection/colonization were admission to exposure to glycopeptides [Odds ratio (OR): 43.84, 95% confidence interval (CI): 1.73-1111.91, P = 0.020], cefoperazone plus sulbactam (OR: 49.56, 95% CI: 1.42-1726.72, P = 0.030) and tracheostomy (OR: 677.82, 95% CI: 2.76-1667, P = 0.020). Age (OR: 1.07, 95% CI: 1.00-1.14, P = 0.04), renal dysfunction (OR: 17.63, 95% CI: 2.34-132.87, P = 0.005) and exposure to cefoperazone plus sulbactam (OR: 8.87, 95% CI: 1.29-61.07, P = 0.026) were independent risk factors for the death of patients with K. pneumoniae infection/colonization. Older age (OR: 1.16, 95% CI: 1.01-1.39, P = 0.011) was an independent risk factor for the death of patients with CRKP infection/colonization. Thirty CRKP strains were all KPC-2-producing resistant strains with genotype of ST-11. CONCLUSION: Exposure to glycopeptides, cefoperazone plus sulbactam and tracheostomy were independent risk factors for CRKP infection/colonization, and older age was an independent risk factor for CRKP infection/colonization caused death. SN - 2047-7732 UR - https://www.unboundmedicine.com/medline/citation/25707874/Risk_factors_for_carbapenem_resistant_Klebsiella_pneumoniae_infection/colonization_and_predictors_of_mortality:_a_retrospective_study_ L2 - http://www.tandfonline.com/doi/full/10.1179/2047773215Y.0000000004 DB - PRIME DP - Unbound Medicine ER -