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. 2016 Sep;57(3):E149-E156.

Epidemiology and biomolecular characterization of carbapenem-resistant klebsiella pneumoniae in an Italian hospital

M L Cristina  1 , M Sartini  1 , G Ottria  1 , E Schinca  1 , N Cenderello  2 , M P Crisalli  2 , P Fabbri  2 , G Lo Pinto  2 , D Usiglio  2 , A M Spagnolo  3
Affiliations

Epidemiology and biomolecular characterization of carbapenem-resistant klebsiella pneumoniae in an Italian hospital

M L Cristina et al. J Prev Med Hyg. 2016 Sep.

Abstract

Objective: To describe the occurrence of CRKP infections in a tertiary care hospital and to analyse the allelic profiles of the clinical strains involved and the most frequent carbapenemases.

Design: The study analyzed cases of infection due to CRKP in the period 2013-2014; 147 cases were recorded, most of which (82.31%) were in-hospital infections.

Setting: A hospital in northern Italy.

Methods: We retrospectively collected: data on patient characteristics and the microbiological characteristics of CRKP. Isolates from 72 of the in-hospital cases underwent molecular typing (MLST); in addition, in each isolate, a procedure for the detection of the blaKPC gene was carried out.

Results: The in-hospital death rate was 24.0% in 2013 and 37.5% in 2014. However, the difference between these two values did not prove statistically significant (P > .05). Analysis of mortality revealed that bloodstream infections were more frequently associated with death than other infections (χ2 = 14.57, P < .001). The age-adjusted Cox proportional hazard model revealed that the patients with bacteremia due to CRKP had a 3-fold higher risk of death (HR 3.11; 95% CI 1.66 - 5.84, P< .001) than those with infections of other sites. MLST revealed that the prevalent allelic profile was ST 512 (79.62%); the most frequent carbapenemase was KPC-3 (83.8%).

Conclusions: Our results are in line with those of recent studies, which have shown that the spread of CRKP in Italy is a matter of concern and that further efforts have to be made to prevent the potential dissemination of carbapenemase-producing clones of K. pneumoniae, whenever possible.

Keywords: Bloodstream infection; Carbapenem-resistant Klebsiella pneumoniae; Mortality.

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Figures

Fig. 1.
Fig. 1.
Kaplan-Meier curves of survival probability of patients with carbapenem-resistant Klebsiella pneumoniae infection, by infection site.
Fig. 2.
Fig. 2.
Percentage distribution of carbapenemases in the various allelic profiles isolated
See this image and copyright information in PMC

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