Antibiotic use and the risk of carbapenem-resistant extended-spectrum- -lactamase-producing Klebsiella pneumoniae infection in hospitalized patients: results of a double case-control study

2011 ◽  
Vol 66 (6) ◽  
pp. 1383-1391 ◽  
Author(s):  
E. I. Kritsotakis ◽  
C. Tsioutis ◽  
M. Roumbelaki ◽  
A. Christidou ◽  
A. Gikas
Keyword(s):  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Antibiotic Use ◽  
Case Control ◽  
Hospitalized Patients ◽  
Carbapenem Resistant ◽  
Extended Spectrum ◽  
Control Study

Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies

2008 ◽  
Vol 29 (12) ◽  
pp. 1099-1106 ◽  
Author(s):  
Gopi Patel ◽  
Shirish Huprikar ◽  
Stephanie H. Factor ◽  
Stephen G. Jenkins ◽  
David P. Calfee
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Patient Survival ◽  
Case Control ◽  
Factors Associated ◽  
Carbapenem Resistant ◽  
Matched Case ◽  
The Impact ◽  
Control Study

Background.Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen.Objective.To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection.Setting.Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City.Design.Two matched case-control studies.Methods.In the first matched case-control study, case patients with carbapenem-resistant K. pneumoniae infection were compared with control patients with carbapenem-susceptible K. pneumoniae infection. In the second case-control study, patients who survived carbapenem-resistant K. pneumoniae infection were compared with those who did not survive, to identify risk factors associated with mortality among patients with carbapenem-resistant K. pneumoniae infection.Results.There were 99 case patients and 99 control patients identified. Carbapenem-resistant K. pneumoniae infection was independently associated with recent organ or stem-cell transplantation (P = .008), receipt of mechanical ventilation (P = .04), longer length of stay before infection (P = .01), and exposure to cephalosporins (P = .02) and carbapenems (P < .001). Case patients were more likely than control patients to die during hospitalization (48% vs 20%; P < .001) and to die from infection (38% vs 12%; P < .001). Removal of the focus of infection (ie, debridement) was independently associated with patient survival (P = .002). The timely administration of antibiotics with in vitro activity against carbapenem-resistant K. pneumoniae was not associated with patient survival.Conclusions.Carbapenem-resistant K. pneumoniae infection is associated with numerous healthcare-related risk factors and with high mortality. The mortality rate associated with carbapenem-resistant K. pneumoniae infection and the limited antimicrobial options for treatment of carbapenem-resistant K. pneumoniae infection highlight the need for improved detection of carbapenem-resistant K. pneumoniae infection, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against carbapenem-resistant K. pneumoniae.

Risk factors for bacteriuria with carbapenem-resistant Klebsiella pneumoniae and its impact on mortality: a case–control study

Infection ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 503-509 ◽  
Author(s):  
S. Shilo ◽  
M. V. Assous ◽  
T. Lachish ◽  
P. Kopuit ◽  
T. Bdolah-Abram ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Control Study

Risk factors for carbapenem-resistant Klebsiella pneumoniae infection/colonization: A case–case-control study

2014 ◽  
Vol 20 (5) ◽  
pp. 293-297 ◽  
Author(s):  
Diamantis P. Kofteridis ◽  
Antonis Valachis ◽  
Dimitra Dimopoulou ◽  
Sofia Maraki ◽  
Athanasia Christidou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Control Study

scholarly journals Risk factors for infection with carbapenem-resistant Klebsiella pneumoniae: a case-case-control study

2014 ◽  
pp. 54-60 ◽  
Author(s):  
Viviana Gómez Rueda ◽  
John Jairo Zuleta Tobón
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Tertiary Care ◽  
Case Control ◽  
Carbapenem Resistant ◽  
Group I ◽  
Tertiary Care Institution ◽  
Control Study

Objetive: To evaluate the association between quinolone exposure and the emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) and to estimate CRKP-specific mortality. Methods: Case-case-control study implemented in a tertiary care institution. Three groups of patients were analyzed: 61 consecutive cases of infection with CRKP (Group I); 61 randomly chosen cases of patients infected with carbapenem-sensitive Klebsiella pneumoniae (CSKP; Group II); and 122 randomly chosen controls without CRKP or CSKP infection. Matching was based on the length of stay in intensive care unit and the date of bacterial isolation. An active search was performed for patients with CRKP and CSKP infection, and prospective cases were included in the study. We compared the results for Groups I and II against those for the controls by using two conditional logistic regression analyses that included infection as the dependent variable and controlled for time at risk and co-morbidities. Results: Exposure to quinolones was not associated with CRKP infection: no association was found in the analysis of CRKP with the controls (OR= 1.7; 95% CI: 0.2-6.5) or in the analysis of CSKP against the controls (OR= 0.6; 95% CI: 0.2-1.6). Use of carbapenems (OR = 3.3; 95% CI: 1.2-9.3) and colonization with CRKP (OR = 3.3; 95% IC: 1.2-9.3) were specific risk factors for infection with CRKP. Mortality associated with CRKP was 61.3%. Conclusion: No association was found between exposure to quinolones and infection with CRKP; however, colonization by CRKP and use of carbapenems are risk factors for infection with CRKP.

Clostridium difficile Among Hospitalized Patients Receiving Antibiotics A Case-Control Study

2005 ◽  
Vol 26 (8) ◽  
pp. 685-690 ◽  
Author(s):  
Scott Modena ◽  
Dilip Bearelly ◽  
Kenneth Swartz ◽  
Frank K. Friedenberg
Keyword(s):  
Intensive Care ◽  
Clostridium Difficile ◽  
Length Of Stay ◽  
Case Control Study ◽  
Macrolide Antibiotic ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Case Control ◽  
Hospitalized Patients ◽  
Control Study

AbstractObjectives:Clostridium difficile is the most common cause of infectious nosocomial diarrhea and can be found in up to 30% of asymptomatic hospitalized patients. Our primary aim was to compare the clinical characteristics of hospitalized patients who received antibiotics and developed C. difficile-associated diarrhea (CDAD) with those of hospitalized patients who received antibiotics and did not develop the disease.Design:Case-control study comprising inpatients at a single institution.Patients:Case-patients were defined as patients who had diarrhea and tested positive for C. difficile. Control-patients (matched 4:1 to case-patients) were defined as patients who received antibiotics for at least 5 days and did not develop CDAD.Results:On univariate analysis, nine variables were associated with CDAD. Only three of the variables, need for intensive care, length of stay, and macrolide antibiotic use, were found to be significant (P < .05) on logistic regression analysis. The odds ratios for status as a CDAD case were 3.68 (CI95, 1.44 to 9.40) for stay in the intensive care unit and 1.03 (CI95, 1.02 to 1.05) for each day of hospital stay. Receipt of macrolide antibiotics reduced risk significantly; the odds ratio was 0.23 (CI95, 0.19 to 0.87).Conclusions:We identified need for intensive care and length of stay as important risk factors for the development of CDAD. We also identified macrolide antibiotic use as protective against its development. Patients receiving intensive care may represent a population to study for targeted prophylaxis.

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