The prevalence of carbapenem-resistant Klebsiella pneumoniae isolates and the effect of risk factors on hospital stay duration and mortality rates
Subject Areas : Bacteriology
1 - Faculty of microbial biotechnology, department of biotechnology, Amol University of special modern technologies, Mazandaran, Iran.
Keywords: CRKP, Hospitalization duration, Intensive care unit, Mortality,
Abstract :
Background & Objectives: The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections has been identified as a serious threat. This study aimed to investigate the prevalence of K. pneumoniae infections, antibiotic resistance patterns, and risk factors involved in increased mortality among patients with CRKP infection. Material and methods: 200 infectious samples were collected from ICU patients. After identifying Klebsiella pneumoniae isolates and examining their antibiotic resistance patterns, the effect of several possible risk factors on hospitalization duration and mortality was investigated using linear regression and a multivariate logistic regression model.
Results: One hundred and twenty-four samples (62%) contained K. pneumoniae isolates. The resistance to carbapenems (54.8%), cephalosporins (72%), fluoroquinolones (87.7%), aminoglycosides (87%), and colistin (75%) was significantly higher among CRKP patients than those susceptible to carbapenem. The proportions of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing isolates were 67.7% and 29%, respectively. Underlying diseases (P= 0.03) and resistance to carbapenem (P=0.001) were two independent risk factors associated with the duration of hospitalization. Additionally, there was a significant association between older age (P=0.04) and resistance to carbapenem (P=0.03) with mortality.
Conclusions: Given the high rate of CRKP, its association to length of hospital stays and patient mortality, and the increase in multidrug-resistant isolates, the need for monitoring of microbial resistance patterns and the prescription of new combination antibiotic regimens could be effective in improving the recovery process and reducing the duration of hospital stays of patients.
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