Risk factors for bloodstream infection with Klebsiella pneumoniae producing VIM-1 metallo-beta-lactamase.
OBJECTIVE
To identify risk factors for bloodstream infections (BSIs) caused by VIM-1-producing Klebsiella pneumoniae (VPKP).


METHODS
Consecutive patients with K. pneumoniae BSIs were identified in three tertiary care hospitals between February 2004 and March 2006. Patients infected with VPKP were designated as cases and those infected with non-VPKP as controls. Potential risk factors for VPKP BSIs were examined by univariate and multivariate analysis.


RESULTS
A total of 178 patients with K. pneumoniae BSIs were identified; 67 (37.6%) were infected with VPKP (cases) and 111 with non-VPKP (controls). In multivariate analysis, cases were more likely to have been in an intensive care unit (ICU) [odds ratio (OR), 6.78; 95% confidence interval (CI), 2.69-17.06; P < 0.001], have had prior exposure to >3 different classes of antibiotics (OR, 12.6; 95% CI, 2.17-73.27; P = 0.01) and have had prior use of carbapenems (OR, 2.83; 95% CI, 1.07-7.49; P = 0.03).


CONCLUSIONS
Stay in an ICU, prior use of carbapenems and prior exposure to >3 different classes of antibiotics were independent predictors for VPKP BSIs. These findings provide guidance for antibiotic policies and infection control strategies to contain the spread of VPKP.
Daikos
George L
GL
First Department of Propaedeutic Medicine, University of Athens, Mikras Asias 75, Athens 115-26, Greece. gdaikos@med.uoa.gr
Vryonis
Evangelos
E
Psichogiou
Mina
M
Tzouvelekis
Leonidas S
LS
Liatis
Stavros
S
Petrikkos
Panayiotis
P
Kosmidis
Chris
C
Tassios
Panayotis T
PT
Bamias
Giorgos
G
Skoutelis
Athanasios
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult; D001618:beta-Lactamases / Q000096:biosynthesis
C417264:VIM-1 metallo-beta-lactamase; D001618:beta-Lactamases