Risk factors for nosocomial carbapenem-resistant Klebsiella infections

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Demiroğlu Bilim University Florence Nightingale Journal of Medicine, vol.5, no.3, pp.124-133, 2019 (Peer-Reviewed Journal)


Objectives: This retrospective case-control study aims to evaluate the clinical outcomes of patients diagnosed with nosocomial carbapenem-resistant Klebsiella infection (CRK), identify risk factors of this infection, and determine mortality rate. Patients and methods: The study group consisted of 54 patients (23 males, 31 females; mean age 53.05±11.3 years, range, 18 to 82 years) diagnosed with CRK infection between January 2014 - July 2018. The control group was randomly selected among patients matched for gender who were hospitalized within the same period (±15 days) and had nosocomial infection but without CRK growth in cultures. Results: Nosocomial CRK infection was most prevalent among the intensive care unit (90.75%). Mechanical ventilation, tracheostomy, presence of nasogastric tube, central venous catheter, elderly age (≥65 years), H2 receptor antagonist treatment, total parenteral nutrition, hospitalization within the past six months, antibiotic use within three months prior to CRK infection, and use of more than two antibiotic groups were identified as risk factors for development of CRK infection. Total mortality rate of the patient group was 31.48%. Conclusion: In order to prevent spread of nosocomial CRK infections, which has gradually narrowing treatment options, there is a need for further prospective multicenter studies on reducing invasive procedures and inappropriate antibiotic use, identifying correctible risk factors, and taking necessary corrective measures. Keywords: Carbapenem-resistant Klebsiella infection, mortality, nosocomial infection, risk factors.