Risk factors for carbapenem-resistant Klebsiella pneumoniae infections in Intensive Care Units: a multicentre case-control study with a competing-risks analysis.

Autor:	Arslan F; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey., Akbulut E; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey., Senbayrak S; Department of Infectious Diseases and Clinical Microbiology, Hamidiye Medical Faculty, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey., Özgültekin A; Department of Anesthesiology and Intensive Care, Hamidiye Medical Faculty, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey., Aksaray S; Department of Medical Microbiology, Hamidiye Medical Faculty, University of Health Sciences, Istanbul, Turkey., Dal HC; Department of Intensive Care, Health Sciences University, Ankara City Hospital, Ankara, Turkey., Emir HO; Department of Intensive Care, Health Sciences University, Ankara City Hospital, Ankara, Turkey., Ankarali H; Department of Biostatistics, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey., Mert A; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey., Vahaboglu H; Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Journal of preventive medicine and hygiene [J Prev Med Hyg] 2024 Jan 01; Vol. 64 (4), pp. E405-E410. Date of Electronic Publication: 2024 Jan 01 (Print Publication: 2023).
DOI:	10.15167/2421-4248/jpmh2023.64.4.2110
Abstrakt:	Aim: This study investigated the risk factors for the development of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections in adult patients in Intensive Care Units (ICUs). Methods: A multicentre case-control study was conducted in ICUs in three tertiary hospitals in Turkey. The cases were patients culture-confirmed CRKP and a condition associated with healthcare-associated infections. Two controls were randomly selected for each case from among all other patients with an ICU stay at least as long as that of the corresponding case-patient. A proportional semiparametric subdistribution hazards regression model was used to assess risk factors for CRKP infection. ICU discharge and non-CRKP-related deaths were treated as competing risks. Results: A total of 120 patients, 44 cases and 76 controls were included in the analysis. Of the controls, 32 were discharged from the ICU and 44 died without acquiring CRKP infection. Endotracheal intubation (hazard ratio [HR]: 1.96, 95% confidence interval [CI]: 1.00-3.868) and type 2 diabetes mellitus (HR: 1.57, 95% CI: 0.888-2.806) were associated with an increased risk of CRKP infection, whereas carbapenem exposure (HR: 0.47, 95% CI: 0.190-1.1175) and the presence of a nasogastric tube (HR: 0.49, 95% CI: 0.277-0.884) were associated with a decreased risk of CRKP infection. Conclusions: Enteral nutrition support via a nasogastric tube may be associated with a reduced risk of CRKP-resistant infections in ICU patients. This hypothesis should be tested with a well-designed study. Competing Interests: The authors declare that they have no competing interests. (©2024 Pacini Editore SRL, Pisa, Italy.)
Databáze:	MEDLINE
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