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. 2021 Jul 12:14:2647-2656.
doi: 10.2147/IDR.S315871. eCollection 2021.

Invasive Klebsiella pneumoniae Infections in Community-Settings and Healthcare Settings

Yue Qiu #  1 , Daojiong Lin #  2 , Yi Xu #  3 , Yibing Cheng  4 , Fang Wang  5 , Qingxiong Zhu  6 , Chunhui Zhu  6 , Chaomin Wan  7 , Yu Zhu  7 , Jianning Tong  8 , Rui Li  8 , Qionghua Zhou  2 , Minxia Chen  3 , Qingwen Shan  9 , Zhiqiang Zhuo  10 , Caihong Wang  10 , Shiyong Zhao  11 , Wen Song  11 , Mei Zeng  1
Affiliations

Invasive Klebsiella pneumoniae Infections in Community-Settings and Healthcare Settings

Yue Qiu et al. Infect Drug Resist. .

Abstract

Objective: To assess clinical characteristics, outcomes and antimicrobial resistance of invasive Klebsiella pneumoniae (KP) infections in Chinese pediatric patients in hospital and community settings.

Methods: This retrospective study was conducted in the nine tertiary hospitals during 2016-2018. The 324 pediatric inpatients who had KP isolated from blood and cerebrospinal fluid and had complete medical records reviewed were included. We analyzed the risk factors, outcomes and antimicrobial resistance pattern of KP-infected patients based on comparison between healthcare-associated KP infections (HAI) and community-acquired infections.

Results: Of the 324 enrolled patients, 275 (84.9%) were clinically defined as HAI, including 175 (63.6%) neonates and 100 (36.4%) aged >28 days. The overall prevalence of CRKP was 38.2% (43.4% in HAI verse 8.7% in CAI, P <0.05). Prematurity (odds ratio (OR): 37.07, 95% CI: 8.29-165.84), hematologic malignancies (OR: 15.52, 95% CI: 1.89-127.14) and invasive mechanical ventilation (OR: 13.09, 95% CI: 1.66-103.56) were independent risk factors for HAI. Patients from rural area (OR: 1.94, 95% CI: 1.12-3.35), invasive mechanical ventilation (OR: 2.33, 95% CI: 1.25-4.33), antibiotic therapy prior to admission (OR: 2.33, 95% CI: 1.25-4.33) and prior hospital stay in the past 30 days (OR: 3.46, 95% CI: 1.87-6.41) were associated with healthcare-associated CRKP infections. Organ dysfunction was independently correlated with poor outcomes (OR: 2.92, 95% CI: 1.23-6.95).

Conclusion: Pediatric invasive KP infections and high prevalence of CRKP infections largely occurred in healthcare settings in China. The adequate and intensified infection control measures should be focused on high-risk hematologic patients, neonatal patients and intubated patients.

Keywords: Klebsiella pneumoniae; children; healthcare-associated infections.

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Conflict of interest statement

All authors declared no potential conflicts of interest to disclose.

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