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Multicenter Study
. 2024 Jan 1;64(4):E405-E410.
doi: 10.15167/2421-4248/jpmh2023.64.4.2110. eCollection 2023 Dec.

Risk factors for carbapenem-resistant Klebsiella pneumoniae infections in Intensive Care Units: a multicentre case-control study with a competing-risks analysis

Ferhat Arslan  1 , Ece Akbulut  1 , Seniha Senbayrak  2 , Asu Özgültekin  3 , Sebahat Aksaray  4 , Hayriye Cankar Dal  5 , Hasan Oktay Emir  5 , Handan Ankarali  6 , Ali Mert  7 , Haluk Vahaboglu  1
Affiliations
Multicenter Study

Risk factors for carbapenem-resistant Klebsiella pneumoniae infections in Intensive Care Units: a multicentre case-control study with a competing-risks analysis

Ferhat Arslan et al. J Prev Med Hyg. .

Abstract

Aim: This study investigated the risk factors for the development of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in adult patients in Intensive Care Units (ICUs).

Methods: A multicentre case-control study was conducted in ICUs in three tertiary hospitals in Turkey. The cases were patients culture-confirmed CRKP and a condition associated with healthcare-associated infections. Two controls were randomly selected for each case from among all other patients with an ICU stay at least as long as that of the corresponding case-patient. A proportional semiparametric subdistribution hazards regression model was used to assess risk factors for CRKP infection. ICU discharge and non-CRKP-related deaths were treated as competing risks.

Results: A total of 120 patients, 44 cases and 76 controls were included in the analysis. Of the controls, 32 were discharged from the ICU and 44 died without acquiring CRKP infection. Endotracheal intubation (hazard ratio [HR]: 1.96, 95% confidence interval [CI]: 1.00-3.868) and type 2 diabetes mellitus (HR: 1.57, 95% CI: 0.888-2.806) were associated with an increased risk of CRKP infection, whereas carbapenem exposure (HR: 0.47, 95% CI: 0.190-1.1175) and the presence of a nasogastric tube (HR: 0.49, 95% CI: 0.277-0.884) were associated with a decreased risk of CRKP infection.

Conclusions: Enteral nutrition support via a nasogastric tube may be associated with a reduced risk of CRKP-resistant infections in ICU patients. This hypothesis should be tested with a well-designed study.

Keywords: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections; Intensive Care Units; Klebsiella pneumoniae; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1.
Fig. 1.
Cumulative incidence by exposure to carbapenem.
Fig. 2.
Fig. 2.
Cumulative incidence in nasogastric tube use.
Fig. 3.
Fig. 3.
Cumulative incidence in endotracheal intubation.
Fig. 4.
Fig. 4.
Cumulative incidence in the presence of diabetes mellitus.
See this image and copyright information in PMC

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References

    1. Frontiers|Colonization, Infection and the Accessory Genome of Klebsiella pneumoniae | Cellular and Infection Microbiology. https://www.frontiersin.org/articles/10.3389/fcimb.2018.00004/full (Accessed on: 9/1/2021). - DOI - PMC - PubMed
    1. Zheng X, Wang J, Xu W, Xu J, Hu J. Clinical and molecular characteristics, risk factors and outcomes of Carbapenem-resistant Klebsiella pneumoniae bloodstream infections in the intensive care unit. Antimicrob Resist Infect Control 2017;6:102. https://doi.org/10.1186/s13756-017-0256-2 10.1186/s13756-017-0256-2 - DOI - PMC - PubMed
    1. Humphries RM, Yang S, Kim S, Muthusamy VR, Russell D, Trout AM, Zaroda T, Cheng QJ, Aldrovandi G, Uslan DZ, Hemarajata P, Rubin ZA. Duodenoscope-Related Outbreak of a Carbapenem-Resistant Klebsiella pneumoniae Identified Using Advanced Molecular Diagnostics. Clin Infect Dis 2017;65:1159-66. https://doi.org/10.1093/cid/cix527 10.1093/cid/cix527 - DOI - PubMed
    1. Holt KE, Wertheim H, Zadoks RN, Baker S, Whitehouse CA, Dance D, Jenney A, Connor TR, Hsu LY, Severin J, Brisse S, Cao H, Wilksch J, Gorrie C, Schultz MB, Edwards DJ, Nguyen KV, Nguyen TV, Dao TT, Mensink M, Minh VL, Nhu NTK, Schultsz C, Kuntaman K, Newton PN, Moore CE, Strugnell RA, Thomson NR. Genomic analysis of diversity, population structure, virulence, and antimicrobial resistance in Klebsiella pneumoniae, an urgent threat to public health. Proc Natl Acad Sci 2015;112:E3574-81. https://doi.org/10.1073/pnas.1501049112 10.1073/pnas.1501049112 - DOI - PMC - PubMed
    1. Paczosa MK, Mecsas J. Klebsiella pneumoniae: going on the offense with a strong defense. Microbiol Mol Biol Rev 2016;80:629-61. https://doi.org/10.1128/MMBR.00078-15 10.1128/MMBR.00078-15 - DOI - PMC - PubMed

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