Risk factors for KPC-producing Klebsiella pneumoniae bacteremia

Brazilian Journal of Infectious Diseases

Felipe F. Tuon²  Jaime L. Rocha¹  Paula Toledo¹  Lavinia N. Arend¹  Camila H. Dias²  Talita M. Leite²  Sergio R. Penteado-filho²  Marcelo Pilonetto¹  Alexandre P. Zavascki¹ 

[1] ,Hospital Universitário Evangélico de Curitiba Division of Infectious and Parasitic Diseases Curitiba PR ,Brazil

关键词: Klebsiella pneumoniae;    Bacteremia risk factors;    Klebsiella pneumoniae;    carbapenemases;    Carbapenems;   

DOI  :  10.1016/j.bjid.2012.08.006

来源: SciELO

【 摘 要 】

The molecular epidemiology of carbapenemase-producing Klebsiella pneumoniae (KPC) has been largely investigated, but limited clinical information is available. A case-control study was performed to evaluate the risk factors for KPC bacteremia in hospitalized patients. Cases were patients with KPC bacteremia and controls were patients with non-KPC bacteremia. A total of 85 patients were included, 18 (21.2%) were KPC, and 67 (78.8%) were non-KPC (40 [59.7%] of them were extended-spectrum beta-lactamase producers). All KPC isolates were type 2 producers. These isolates belong to five distinct clones. Multivariate analysis showed that age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.02 - 1.11; p = 0.004), presence of mechanical ventilation (OR, 11.1; 95% CI, 1.92 - 63.3; p = 0.007) and fluoroquinolone exposure during hospitalization (OR, 28.9; 95% CI, 1.85 - 454.6; p = 0.02) were independent risk factors for KPC in patients with K. pneumoniae bacteremia. Factors associated with severity of illness, such as age and mechanical ventilation, seem to be the main risks factors for KPC. Fluoroquinolones use might be a risk factor for KPC bacteremia. Further investigations on risk factors for KPC are warranted.

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