title: Risk factors of carbapenem-resistant Klebsiella pneumoniae infection: a serious threat in ICUs.
abstract: BACKGROUND
  Nosocomial infections caused by Carbapenem-resistant Klebsiella pneumoniae (CRKP) are increasing. Our aim in this study was to investigate the risk factors of CRKP infections.
  
  
  METHODS
  A retrospective cohort study was performed between 1 January and 31 December 2012 in ICU patients. Data was taken from the hospital infection control database for CRKP. The clinical samples collected from the patients were tested by an automatized system and disk diffusion. SPSS software v11.5 was used for statistical analysis.
  
  
  RESULTS
  Totally, 105 Klebsiella pneumoniae isolates were found in 2012 and the carbapenem resistance rate was 48%. The first episode of infection was taken into risk factor analysis. Of the 98 patients, 61 (62.2%) were male and the mean and median ages were 30.4±29.8 and 25 (0-93). The length of stay was longer in the resistant group (p=0.026). Mortality was 48% in the whole group and similar between groups (p=0.533). There was a relationship between meropenem and third-generation cephalosporin use and resistance (OR 3.244 (1.193-8.819) and OR: 3.590 (1.056-12.209). The other risk factors in univariate analysis were: Immunosuppression OR: 2.186 (1.754-2.724), nasogastric catheter OR: 3.562 (1.317-9.634), peripheral arterial catheter OR: 2.545 (1.027-6.307), and being admitted to the neurosurgical unit OR: 4.324 (1.110-16.842).
  
  
  CONCLUSIONS
  Restriction of third-generation cephalosporin and carbapenem use and invasive procedures, along with infection control precautions and disinfection policies, may be effective in reducing the carbapenem resistance in ICUs.
authors.affiliation: Department of Infectious Diseases, Çukurova University, Adana, Turkey.
authors.forename: Aslıhan
authors.initials: A
authors.lastname: Candevir Ulu
authors.affiliation: Department of Infectious, Çukurova University, Adana, Turkey.
authors.forename: Behice
authors.initials: B
authors.lastname: Kurtaran
authors.affiliation: Department of Infectious Diseases, Çukurova University, Adana, Turkey.
authors.forename: Ayşe Seza
authors.initials: AS
authors.lastname: Inal
authors.affiliation: Department of Infectious Diseases, Çukurova University, Adana, Turkey.
authors.forename: Süheyla
authors.initials: S
authors.lastname: Kömür
authors.affiliation: Department of Microbiology, Çukurova University, Adana, Turkey.
authors.forename: Filiz
authors.initials: F
authors.lastname: Kibar
authors.affiliation: Department of Infection Control Commitee, Çukurova University, Adana, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Yapıcı Çiçekdemir
authors.affiliation: Department of Infection Control Commitee, Çukurova University, Adana, Turkey.
authors.forename: Seval
authors.initials: S
authors.lastname: Bozkurt
authors.affiliation: Department of Infection Control Commitee, Çukurova University, Adana, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Gürel
authors.affiliation: Department of Infection Control Commitee, Çukurova University, Adana, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Kılıç
authors.affiliation: Department of Microbiology, Çukurova University, Adana, Turkey.
authors.forename: Akgün
authors.initials: A
authors.lastname: Yaman
authors.affiliation: Department of Infectious Diseases, Çukurova University, Adana, Turkey.
authors.forename: Hasan Salih Zeki
authors.initials: HS
authors.lastname: Aksu
authors.affiliation: Department of Infectious Diseases, Çukurova University, Adana, Turkey.
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Taşova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D015780:Carbapenems / Q000737:chemistry*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012984:Software; D055815:Young Adult
chemical_list: D015780:Carbapenems