Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors
Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study. The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed. A t...
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| Veröffentlicht in: | Journal of infection in developing countries 2014-01, Vol.8 (1), p.44-49 |
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| creator | Dizbay, Murat Guzel Tunccan, Ozlem Karasahin, Omer Aktas, Firdevs |
| description | Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study.
The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed.
A total of 720 patients were included in the study. Carbapenem resistance among Klebsiella spp. were significantly increased between 2003 and 2007 (p |
| doi_str_mv | 10.3855/jidc.3091 |
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The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed.
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.
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.</description><identifier>ISSN: 1972-2680</identifier><identifier>ISSN: 2036-6590</identifier><identifier>EISSN: 1972-2680</identifier><identifier>DOI: 10.3855/jidc.3091</identifier><identifier>PMID: 24423711</identifier><language>eng</language><publisher>Italy: Journal of Infection in Developing Countries</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - pharmacology ; Antibiotics ; beta-Lactam Resistance ; Carbapenems - pharmacology ; Cross Infection - epidemiology ; Cross Infection - microbiology ; Female ; Hospitals, University ; Humans ; Incidence ; Klebsiella - drug effects ; Klebsiella - enzymology ; Klebsiella - isolation & purification ; Klebsiella Infections - epidemiology ; Klebsiella Infections - microbiology ; Male ; Middle Aged ; Nosocomial infections ; Ostomy ; Retrospective Studies ; Risk Factors ; Turkey - epidemiology ; Young Adult</subject><ispartof>Journal of infection in developing countries, 2014-01, Vol.8 (1), p.44-49</ispartof><rights>2014. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c313t-e2ea59541cb9b0df74399867654a83877025ea0fa14dc1e23cfd56126a3c36bc3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27933,27934</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24423711$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dizbay, Murat</creatorcontrib><creatorcontrib>Guzel Tunccan, Ozlem</creatorcontrib><creatorcontrib>Karasahin, Omer</creatorcontrib><creatorcontrib>Aktas, Firdevs</creatorcontrib><title>Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors</title><title>Journal of infection in developing countries</title><addtitle>J Infect Dev Ctries</addtitle><description>Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study.
The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed.
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.
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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotics</subject><subject>beta-Lactam Resistance</subject><subject>Carbapenems - pharmacology</subject><subject>Cross Infection - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Female</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Incidence</subject><subject>Klebsiella - drug effects</subject><subject>Klebsiella - enzymology</subject><subject>Klebsiella - isolation & purification</subject><subject>Klebsiella Infections - epidemiology</subject><subject>Klebsiella Infections - microbiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nosocomial infections</subject><subject>Ostomy</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Turkey - epidemiology</subject><subject>Young Adult</subject><issn>1972-2680</issn><issn>2036-6590</issn><issn>1972-2680</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkUtr3DAUhUVpaB7ton8gCLppF57oYUlWdyGkachANsnayPJ1ooktObp2YCA_vh4mLSWrexYfh3P5CPnK2UpWSp1tQutXkln-gRxxa0QhdMU-_pcPyTHihjFlpeKfyKEoSyEN50fk9XKA_ADRA00d9S43boQIQ5EBA04uTvSmhwYD9L2jOI4rGmIHfgop4hKpo3dzfgr4SOcYXiBjmLb0MeEYJtf_pDCGFoaQ-vSwpS62NAd8op3zU8r4mRx0rkf48nZPyP2vy7uL38X69ur64nxdeMnlVIAAp6wquW9sw9rOlNLaShutSlfJyhgmFDjWOV62noOQvmuV5kI76aVuvDwh3_e9Y07PM-BUDwH97qMIacaal5YZo5nUC_rtHbpJc47LuloozYQRUtiF-rGnfE6IGbp6zGFweVtzVu-U1Dsl9U7Jwp6-Nc7NAO0_8q8D-QecEohi</recordid><startdate>20140115</startdate><enddate>20140115</enddate><creator>Dizbay, Murat</creator><creator>Guzel Tunccan, Ozlem</creator><creator>Karasahin, Omer</creator><creator>Aktas, Firdevs</creator><general>Journal of Infection in Developing Countries</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8C1</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20140115</creationdate><title>Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors</title><author>Dizbay, Murat ; Guzel Tunccan, Ozlem ; Karasahin, Omer ; Aktas, Firdevs</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c313t-e2ea59541cb9b0df74399867654a83877025ea0fa14dc1e23cfd56126a3c36bc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - pharmacology</topic><topic>Antibiotics</topic><topic>beta-Lactam Resistance</topic><topic>Carbapenems - pharmacology</topic><topic>Cross Infection - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Female</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Incidence</topic><topic>Klebsiella - drug effects</topic><topic>Klebsiella - enzymology</topic><topic>Klebsiella - isolation & purification</topic><topic>Klebsiella Infections - epidemiology</topic><topic>Klebsiella Infections - microbiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nosocomial infections</topic><topic>Ostomy</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Turkey - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dizbay, Murat</creatorcontrib><creatorcontrib>Guzel Tunccan, Ozlem</creatorcontrib><creatorcontrib>Karasahin, Omer</creatorcontrib><creatorcontrib>Aktas, Firdevs</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Public Health Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of infection in developing countries</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dizbay, Murat</au><au>Guzel Tunccan, Ozlem</au><au>Karasahin, Omer</au><au>Aktas, Firdevs</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors</atitle><jtitle>Journal of infection in developing countries</jtitle><addtitle>J Infect Dev Ctries</addtitle><date>2014-01-15</date><risdate>2014</risdate><volume>8</volume><issue>1</issue><spage>44</spage><epage>49</epage><pages>44-49</pages><issn>1972-2680</issn><issn>2036-6590</issn><eissn>1972-2680</eissn><abstract>Risk factors for nosocomial carbapenem-resistant Klebsiella spp. (CRK) infections were analyzed in this study.
The incidence, clinical characteristics, risk factors, antimicrobial susceptibility, and outcomes of CRK infections during a seven-year period (2004-2010) were retrospectively analyzed.
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.
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.</abstract><cop>Italy</cop><pub>Journal of Infection in Developing Countries</pub><pmid>24423711</pmid><doi>10.3855/jidc.3091</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - pharmacology Antibiotics beta-Lactam Resistance Carbapenems - pharmacology Cross Infection - epidemiology Cross Infection - microbiology Female Hospitals, University Humans Incidence Klebsiella - drug effects Klebsiella - enzymology Klebsiella - isolation & purification Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Male Middle Aged Nosocomial infections Ostomy Retrospective Studies Risk Factors Turkey - epidemiology Young Adult |
| title | Emergence of carbapenem-resistant Klebsiella spp. infections in a Turkish university hospital: epidemiology and risk factors |
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