BACKGROUND: Carbapenem resistance among isolates of Klebsiella pneumoniae has been unusual. OBJECTIVES: To identify risk factors for infection with carbapenem-resistant K. pneumoniae (CRKP) and to characterize microbiological aspects of isolates associated with these infections. DESIGN: Retrospective case-control study. SETTING: A 900-bed tertiary care hospital. RESULTS: From January 2006 through April 2007, K. pneumoniae was isolated from 461 inpatients; 88 had CRKP infection (case patients), whereas 373 had carbapenem-susceptible K. pneumoniae infection (control subjects). The independent risk factors for infection with CRKP were prior fluoroquinolone use (odds ratio [OR], 1.87 [95% confidence interval [CI], 1.07-3.26]; P=.026), previous receipt of a carbapenem drug (OR, 1.83 [95% CI, 1.02-3.27]; P=.042), admission to the intensive care unit (OR, 4.27 [95% CI, 2.49-7.31]; P<.001), and exposure to at least 1 antibiotic drug before isolation of K. pneumoniae (OR, 3.93 [95% CI, 1.15-13.47]; P=.029). All CRKP isolates carried the bla(KPC) gene. Approximately 90% of the tested isolates carried the bla(KPC-2) allele, suggesting patient-to-patient transmission. Almost all CRKP isolates were resistant to all antibiotics, except to colistin (resistance rate, 4.5%), gentamicin (resistance rate, 7%), and tigecycline (resistance rate, 15%). CONCLUSIONS: CRKP should be regarded as an emerging clinical threat. Because these isolates are resistant to virtually all commonly used antibiotics, control of their spread is crucial.
BACKGROUND:Carbapenem resistance among isolates of Klebsiella pneumoniae has been unusual. OBJECTIVES: To identify risk factors for infection with carbapenem-resistant K. pneumoniae (CRKP) and to characterize microbiological aspects of isolates associated with these infections. DESIGN: Retrospective case-control study. SETTING: A 900-bed tertiary care hospital. RESULTS: From January 2006 through April 2007, K. pneumoniae was isolated from 461 inpatients; 88 had CRKP infection (case patients), whereas 373 had carbapenem-susceptible K. pneumoniae infection (control subjects). The independent risk factors for infection with CRKP were prior fluoroquinolone use (odds ratio [OR], 1.87 [95% confidence interval [CI], 1.07-3.26]; P=.026), previous receipt of a carbapenem drug (OR, 1.83 [95% CI, 1.02-3.27]; P=.042), admission to the intensive care unit (OR, 4.27 [95% CI, 2.49-7.31]; P<.001), and exposure to at least 1 antibiotic drug before isolation of K. pneumoniae (OR, 3.93 [95% CI, 1.15-13.47]; P=.029). All CRKP isolates carried the bla(KPC) gene. Approximately 90% of the tested isolates carried the bla(KPC-2) allele, suggesting patient-to-patient transmission. Almost all CRKP isolates were resistant to all antibiotics, except to colistin (resistance rate, 4.5%), gentamicin (resistance rate, 7%), and tigecycline (resistance rate, 15%). CONCLUSIONS: CRKP should be regarded as an emerging clinical threat. Because these isolates are resistant to virtually all commonly used antibiotics, control of their spread is crucial.
Authors: Meredith G Jernigan; Ellen G Press; M Hong Nguyen; Cornelius J Clancy; Ryan K Shields Journal: Antimicrob Agents Chemother Date: 2012-03-19 Impact factor: 5.191
Authors: A Smithson; J Ramos; M T Bastida; S Bernal; N Jove; E Niño; N Msabri; R Porrón Journal: Eur J Clin Microbiol Infect Dis Date: 2015-09-25 Impact factor: 3.267
Authors: D Delle Rose; P Pezzotti; E Fortunato; P Sordillo; S Gini; S Boros; M Meledandri; M T Gallo; G Prignano; R Caccese; M D'Ambrosio; G Citterio; M Rocco; F Leonardis; S Natoli; C Fontana; M Favaro; M G Celeste; T Franci; G P Testore; M Andreoni; L Sarmati Journal: Eur J Clin Microbiol Infect Dis Date: 2016-06-06 Impact factor: 3.267