[Multidrug-resistant Klebsiella pneumoniae, predisposing factors and associated mortality in a tertiary-care hospital in Colombia].
BACKGROUND
Bacterial resistance to antibiotics is a serious public health problem that is increasing worldwide. Resistant (R) Klebsiella pneumoniae is one of the main pathogens isolated in nosocomial infections. The aim of this study was to explore risk factors associated with the acquisition of infection by R-K. pneumoniae and mortality.


METHODS
Prospective cohort study conducted in a hospital of high complexity of Medellin, October/2009-April/2010. The exposed group was defined as patients infected with R-K. pneumoniae (producing b-lactamases or carbapenemases). In order to identify risk factors associated with infection by R-K. pneumoniae and 30 day mortality, logistic regression and Cox proportional hazards regression were used.


RESULTS
243 patients were included in the study, 84 infected with R-K. pneumoniae and 159 infected with susceptible K. pneumoniae. Female sex (OR = 2.51 95% 1.37 to 4.6), the co-existence of cardiovascular disease (OR = 2.13 95% CI 1.14 to 3.99), previous use of ceftriaxone (OR = 9.52 95% CI 2.63 to 34.46) and carbapenems (OR = 4.23 95% CI 2.41 to 7.42) were risk factors associated to infection with R-K. pneumoniae. Some predictors of mortality were malignant neoplasia (HR = 4.43 95% CI 2.13 to 9.22) and mechanical ventilation (HR = 3.81 95% CI 1.99 to 7.28). There was no difference in 30-day mortality when comparing patients in both groups.


CONCLUSIONS
Female gender, cardiovascular disease and previous use of antimicrobials were associated with infection by R-K. pneumoniae. Thirty-day mortality was similar in both groups of patients.
Universidad Pontificia Bolivariana, Medellín, Colombia. linamariae@hotmail.com
Lina M
LM
Echeverri-Toro
Zulma V
ZV
Rueda
Wilmar
W
Maya
Yuli
Y
Agudelo
Sigifredo
S
Ospina
D000293:Adolescent; D000328:Adult; D003105:Colombia / Q000453:epidemiology; D003428:Cross Infection / Q000382:microbiology / Q000401:mortality*; D024901:Drug Resistance, Multiple, Bacterial; D004812:Epidemiologic Methods; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology / Q000401:mortality*; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism
D001618:beta-Lactamases