title: Carbapenem-ResistantKlebsiella pneumoniaeInfection in Three New York City Hospitals Trended Downwards From 2006 to 2014.
abstract: BACKGROUND
  Carbapenem-resistantKlebsiella pneumoniae(CRKP) infection is a rising public health threat since its first outbreaks in New York City (NYC) in the early 2000s. We investigated annual trends of CRKP infection in hospital-acquired infections (HAIs) and community-onset infections (COIs) treated in 3 NYC hospitals from 2006 to 2014.
  
  
  METHODS
  We extractedK pneumoniaeinfection data including carbapenem susceptibility and anatomical sites, compared clinical characteristics between CRKP and carbapenem-susceptibleK pneumoniaeinfections, and determined CRKP infection proportions in totalK pneumoniaeinfections in HAI and COI to identify statistically significant trends from 2006 to 2014 using the Cochran-Armitage trend test.
  
  
  RESULTS
  Carbapenem-resistantK pneumoniaecontributed 17.3% (601 of 3477) of hospital-acquiredK pneumoniaeinfection compared with 7.7% (149 of 1926) in COI from 2006 to 2014. Carbapenem-resistantK pneumoniaeproportions in HAI and COI were positively correlated over time (r= 0.83,P< .01), and there were downward annual trends of CRKP proportions from 2006 to 2014 in both HAI and COI (25.8% to 10.5% in HAI,P< .001; 13.6% to 3.1% in COI,P< .001). By anatomical site, significant downward annual trends were present only in urinary tract infection (P< .001 for both HAI and COI) from 2006 to 2014.
  
  
  CONCLUSIONS
  Annual trends of CRKP proportions from 2006 to 2014 were downward in both HAI and COI, and HAI and COI were positively correlated. Efforts to reduce and prevent CRKP infections in both hospital and community settings were successful and warrant continuation.
authors.affiliation: Mailman School of Public Health,; Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.
authors.forename: Sun O
authors.initials: SO
authors.lastname: Park
authors.affiliation: School of Nursing , and.
authors.forename: Jianfang
authors.initials: J
authors.lastname: Liu
authors.affiliation: College of Physicians and Surgeons, Columbia University , New York.
authors.forename: E Yoko
authors.initials: EY
authors.lastname: Furuya
authors.affiliation: Mailman School of Public Health,; School of Nursing, and.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
keywords: carbapenem-resistant Klebsiella pneumoniae (CRKP); carbapenem-susceptible Klebsiella pneumoniae (CSKP); community-onset infection (COI); hospital-acquired infection (HAI).