Risk factors for the acquisition of carbapenem-resistant Klebsiella pneumoniae among hospitalized patients.
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.
Kwak
Yee Gyung
YG
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.
Choi
Sang-Ho
SH
Choo
Eun Ju
EJ
Chung
Jin-Won
JW
Jeong
Jin-Yong
JY
Kim
Nam Joong
NJ
Woo
Jun-Hee
JH
Ryu
Jiso
J
Kim
Yang Soo
YS
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
D015780:Carbapenems