title: Risk factors for the acquisition of carbapenem-resistant Klebsiella pneumoniae among hospitalized patients.
abstract: The isolation of carbapenem-resistant Klebsiella pneumoniae (CRKP) has been increasingly reported. However, no study analyzing potential risk factors for the acquisition of CRKP has been published as of now. We therefore performed a case-control study to determine the risk factors for the acquisition of CRKP. CRKP was nosocomially isolated from 30 patients between January 1997 and August 2003. Control patients were randomly selected at a ratio of 4:1 from the same medical or surgical services from which patients were receiving care when isolation of CRKP occurred. Risk factors for CRKP were previous use of carbapenem (adjusted odds ratio [AOR], 28.68; 95% confidence interval [CI], 9.08-90.55) and cephalosporin (AOR, 4.10; 95% CI, 1.35-12.43). In contrast, previous use of fluoroquinolone was negatively associated with isolation of CRKP (AOR, 0.26; 95% CI 0.07-0.97); however, the possibility of selection bias cannot be ruled out. Our results suggest that the nosocomial isolation of CRKP is strongly favored by the selection pressure of carbapenem.
authors.affiliation: Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Center for Antimicrobial Resistance and Microbial Genetics, University of Ulsan, Seoul, Korea.
authors.forename: Yee Gyung
authors.initials: YG
authors.lastname: Kwak
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Choo
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Jeong
authors.forename: Nam Joong
authors.initials: NJ
authors.lastname: Kim
authors.forename: Jun-Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Jiso
authors.initials: J
authors.lastname: Ryu
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D015780:Carbapenems / Q000494:pharmacology*; D016022:Case-Control Studies; D024881:Drug Resistance, Bacterial; D005260:Female; D006760:Hospitalization; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D015780:Carbapenems