scholarly journals Risk Factors Affecting Patterns of Antibiotic Resistance and Treatment Efficacy in Extreme Drug Resistance in Intensive Care Unit-Acquired Klebsiella Pneumoniae Infections: A 5-Year Analysis

2019 ◽  
Vol 25 ◽  
pp. 174-183 ◽  
Author(s):  
Bulent Durdu ◽  
Meliha Meric Koc ◽  
Ismail N. Hakyemez ◽  
Yasemin Akkoyunlu ◽  
Hayrettin Daskaya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Treatment Efficacy ◽  
Factors Affecting ◽  
Extreme Drug Resistance

Carbapenem-Resistant Klebsiella pneumoniae Outbreak in a Neonatal Intensive Care Unit: Risk Factors for Mortality

2020 ◽  
Author(s):  
Meltem Bor ◽  
Ozkan Ilhan
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Congenital Anomalies ◽  
Neonatal Intensive Care ◽  
Carbapenem Resistant ◽  
Group 2 ◽  
Antifungal Use ◽  
Group 1

Abstract Aim The aim of our study was to determine the factors associated with mortality in neonates with carbapenem-resistant Klebsiella pneumoniae (CRKP). Material and methods This retrospective, single-center study was conducted in the Neonatal Intensive Care Unit of Harran University Faculty of Medicine between January 2017 and July 2018 who had CRKP growth in their blood, urine or cerebrospinal fluid cultures. The discharged group was designated as the control group (Group 1), whereas the group that faced mortality was classified as the case group (Group 2). The demographic data, clinical findings and laboratory and microbiological results of the two groups were compared to identify risk factors. Results A total of 58 patients (36 in Group 1 and 22 in Group 2) exhibited CRKP growth during the study period. Low birth weight (p = 0.039), previous antifungal (p = 0.002) or amikacin use (p = 0.040), congenital anomalies (p = 0.002), total parenteral nutrition (TPN) administration (p = 0.002), surgery (p = 0.035), thrombocytopenia (p = 0.007), low platelet mass index (p = 0.011), elevated C-reactive protein (p = 0.004), high carbapenem minimum inhibitory concentration (MIC) (p = 0.029) and high amikacin MIC (p = 0.019) were associated with mortality. In a multivariate regression analysis, previous antifungal use (p = 0.028), congenital anomalies (p = 0.032) and TPN use (p = 0.013) were independent factors in predicting mortality. Conclusion Previous antifungal use, congenital anomalies and TPN use were found to be independent risk factors for mortality in neonates with CRKP infection.

scholarly journals Characteristics of Carbapenemase-Producing Klebsiella pneumoniae Isolated in the Intensive Care Unit of the Largest Tertiary Hospital in Bangladesh

2021 ◽  
Vol 11 ◽  
Author(s):  
Takashi Okanda ◽  
Anwarul Haque ◽  
Takuro Koshikawa ◽  
Amirul Islam ◽  
Qumrul Huda ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Drug Resistance ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Tertiary Hospital ◽  
Antimicrobial Treatment ◽  
Antimicrobial Drug ◽  
New Delhi ◽  
Antimicrobial Drug Resistance ◽  
Sequence Types

For addressing the issue of antimicrobial drug resistance in developing countries, it is important to investigate the characteristics of carbapenemase-producing organisms. We aimed to genetically characterize a carbapenemase-producing Klebsiella pneumoniae (CPKP) isolated in the intensive care unit of a tertiary hospital in Bangladesh. The number of CPKP isolates were 43/145 (30%), of which pandrug-resistant (PDR) strains were 14%. These carbapenemases were New Delhi metallo-beta-lactamase (NDM)-1 (53%), NDM-5 (14%), oxacillinase (OXA)-181 (12%), OXA-232 (10%), NDM-5 + OXA-181 (5%), and NDM-5 + OXA-232 (2%). Many CPKP isolates harbored a variety of resistance genes, and the prevalence of 16S rRNA methyltransferase was particularly high (91%). The 43 CPKP isolates were classified into 14 different sequence types (STs), and the common STs were ST34 (26%), ST147 (16%), ST11 (9%), ST14 (9%), ST25 (7%), and ST231 (7%). In this study, PDR strains were of three types, ST147, ST231, and ST14, and their PDR rates were 57, 33, and 25%, respectively. The spread of the antimicrobial drug resistance of CPKP in Bangladesh was identified. In particular, the emergence of PDR is problem, and there may be its spread as a superbug of antimicrobial treatment.

Risk factors for infection and predictors of mortality among patients with KPC-producing Klebsiella pneumoniae bloodstream infections in the intensive care unit

2014 ◽  
Vol 46 (9) ◽  
pp. 642-648 ◽  
Author(s):  
Matthaios Papadimitriou-Olivgeris ◽  
Markos Marangos ◽  
Myrto Christofidou ◽  
Fotini Fligou ◽  
Christina Bartzavali ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infections ◽  
Predictors Of Mortality

Characteristics, risk factors and outcomes of carbapenem-resistant Klebsiella pneumoniae infections in the intensive care unit

2015 ◽  
Vol 70 (6) ◽  
pp. 592-599 ◽  
Author(s):  
Konstantinos Z. Vardakas ◽  
Dimitrios K. Matthaiou ◽  
Matthew E. Falagas ◽  
Elli Antypa ◽  
Asimoula Koteli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistant

Risk factors and predictors of mortality for KPC-producing Klebsiella pneumoniae bactereamia during intensive care unit stay

2013 ◽  
Vol 30 ◽  
pp. 187-187
Author(s):  
F. Fligou ◽  
M. Papadimitriou-Olivgeris ◽  
C. Sklavou ◽  
E. D. Anastassiou ◽  
M. Marangos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Intensive Care Unit Stay ◽  
Predictors Of Mortality

scholarly journals Antibiotic resistance pattern in intensive care unit of a tertiary care teaching hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 906
Author(s):  
Amit Bhatia ◽  
Juhi Kalra ◽  
Saurabh Kohli ◽  
Barnali Kakati ◽  
Reshma Kaushik
Keyword(s):  
Intensive Care Unit ◽  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Gram Negative Bacteria ◽  
Gram Positive ◽  
Gram Negative ◽  
Gram Positive Bacteria

Background: Antimicrobials are a major class of drugs prescribed in Intensive Care Unit (ICU). Widespread use of empirical antibiotic therapy has facilitated the emergence of drug resistance, since empirical therapy is very often initiated at the outset, even before culture and sensitivity reports are available. The problem of drug resistance is on a rise, therefore, this study was planned to assess the drug resistance and sensitivity patterns of the blood isolates recovered from ICU.Methods: An observational- prospective study was conducted in the Tertiary care teaching hospital over a period of twelve months to assess antibiotic resistance and sensitivity pattern. A total of 104 consecutive patients receiving antibiotics in the ICU and having blood cultures with significant growth were included in the study. Blood sample was collected and after obtaining a culture growth, the identification and antimicrobial sensitivity testing was done.Results: Blood stream infection by Gram-negative bacteria (50.96%) was more common than Gram-positive bacteria (49.04%). Coagulase negative Staphylococci (CoNS) was the predominant single blood culture isolate (35.58%). Klebsiella pneumoniae (13.46%), Escherichia coli (12.50%), Acinetobacter baumannii complex (7.69%) were commonly isolated gram negative organisms. Gram positive isolates were resistant to beta lactams in maximum patients whereas Tigecycline, Linezolid, Daptomycin, Vancomycin, Nitrofurantoin and Teicoplanin were sensitive against them. Common gram negative isolates were sensitive to Colistin and Tigecycline but resistant to most of the antibiotics.Conclusions: A preponderance of gram negative bacteria over gram positive bacteria was noted with a higher degree of resistance to most of the first line antimicrobial agents. 

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