Risk factors for the acquisition of carbapenem-resistant Klebsiella pneumoniae among hospitalized patients
Risk factors for the acquisition of carbapenem-resistant Klebsiella pneumoniae among hospitalized patients
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DOI：
10.1089/mdr.2005.11.165
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发表时间：
2005-06-01
影响因子：
2.6
通讯作者：
Kim, YS
中科院分区：
文献类型：
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作者：
Kwak, YG;Choi, SH;Kim, YS
碳青霉烯类耐药肺炎克雷伯菌（CRKP）的分离报道越来越多。然而，到目前为止，还没有研究分析收购CRKP的潜在风险因素。因此，我们进行了一项病例对照研究，以确定获得CRKP的风险因素。1997年1月至2003年8月期间，从30例患者中分离出CRKP。对照组患者以4：1的比例从CRKP隔离发生时患者接受护理的相同医疗或外科服务中随机选择。CRKP的风险因素为既往使用碳青霉烯（校正比值比[AOR]，28.68; 95%置信区间[CI]，9.08-90.55）和头孢菌素（AOR，4.10; 95% CI，1.35-12.43）。相反，既往使用氟喹诺酮类药物与CRKP分离呈负相关（AOR，0.26; 95% CI 0.07-0.97）;然而，不能排除选择偏倚的可能性。我们的研究结果表明，CRKP的医院隔离受到碳青霉烯选择压力的强烈支持。
The isolation of carbapenem-resistant Klebsiella pneumoniae (CRKP) has been increasingly reported. However, no study analyzing potential risk factors for the acquisition of CRKP has been published as of now. We therefore performed a case-control study to determine the risk factors for the acquisition of CRKP. CRKP was nosocomially isolated from 30 patients between January 1997 and August 2003. Control patients were randomly selected at a ratio of 4:1 from the same medical or surgical services from which patients were receiving care when isolation of CRKP occurred. Risk factors for CRKP were previous use of carbapenem (adjusted odds ratio [AOR], 28.68; 95% confidence interval [CI], 9.08-90.55) and cephalosporin (AOR, 4.10; 95% CI, 1.35-12.43). In contrast, previous use of fluoroquinolone was negatively associated with isolation of CRKP (AOR, 0.26; 95% CI 0.07-0.97); however, the possibility of selection bias cannot be ruled out. Our results suggest that the nosocomial isolation of CRKP is strongly favored by the selection pressure of carbapenem.