scholarly journals Risk Factors for and Clinical Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Nosocomial Infections: A Retrospective Study in a Tertiary Hospital in Beijing, China

2021 ◽  
Vol Volume 14 ◽  
pp. 1393-1401
Author(s):  
Huijuan Zhang ◽  
Zhe Guo ◽  
Yan Chai ◽  
Yi-Peng Fang ◽  
Xiangdong Mu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Klebsiella Pneumoniae ◽  
Clinical Outcomes ◽  
Nosocomial Infections ◽  
Tertiary Hospital ◽  
Carbapenem Resistant ◽  
Beijing China

scholarly journals Risk Factors and Outcomes for Carbapenem-Resistant Klebsiella pneumoniae Isolation, Stratified by Its Multilocus Sequence Typing: ST258 Versus Non-ST258

2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Sorabh Dhar ◽  
Emily T. Martin ◽  
Paul R. Lephart ◽  
John P. McRoberts ◽  
Teena Chopra ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Klebsiella Pneumoniae ◽  
Molecular Epidemiology ◽  
Clinical Outcomes ◽  
Multilocus Sequence Typing ◽  
Clinical Impact ◽  
Sequence Type ◽  
Epidemiological Investigation ◽  
Carbapenem Resistant

Abstract A “high risk” clone of carbapenem-resistant Klebsiella pneumoniae (CRKP) identified by multilocus sequence typing (MLST) as sequence type (ST) 258 has disseminated worldwide. As the molecular epidemiology of the CRE pandemic continues to evolve, the clinical impact of non-ST258 strains is less well defined. We conducted an epidemiological investigation of CRKP based on strains MLST. Among 68 CRKP patients, 61 were ST258 and 7 belonged to non-ST258. Klebsiella pneumoniae ST258 strains were significantly associated with blaKPC production and with resistance to an increased number of antimicrobials. Clinical outcomes were not different. Based on this analysis, one cannot rely solely on the presence of blaKPC in order to diagnose CRKP.

scholarly journals Molecular Epidemiology, Risk Factors and Outcomes of Carbapenem-Resistant Klebsiella Pneumoniae Infection in Eastern China: for A Retrospective Study Over 4 Years

2020 ◽  
Author(s):  
Dongmei Zhao ◽  
Hongru Li ◽  
Chengcheng Yue ◽  
Yanyan Liu ◽  
Ying Ye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Dominant Role ◽  
Eastern China ◽  
Tertiary Hospital ◽  
Empirical Treatment ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Significant Difference ◽  
Hospital Stays

Abstract Objectives: Carbapenem-resistant Klebsiella pneumoniae (CRKP) have undergone extensive dissemination in worldwide resulting in increased mortality. We performed a retrospective analysis of epidemiology and risk factors for CRKP infection in a general teaching hospital in China.Methods: A molecular and clinical study were conducted for 98 CRKP in a tertiary hospital from January 2013 to December 2016. Carbapenemase gene detection, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) were performed. Logistic regression was also used to identify the risk factors associating with the 30-day mortality.Results: The producition of KPC cabapenemase was the main resistant mechanism and increased annually with a significant difference. However, the molecular outcome revealed the dominance and diversity in CRKP with 24 sequence types (STs) and 59 PFGE types (PTs ). The ST11 CRKP were documented as the predominant strains in our study, which showed a significant increasing trend year by year. Additionally, the predominant ST11 CRKP corresponding to PT10 and PT15 remained a typical fashion. Of note, the new advantage PT09 or PT16 were just discovered in 2016 which also corresponding to ST11. Meanwhile, the factors on 30-day mortality and ST11 proportionality with CRKP infection were assessed, which showed that ST11, appropriate empirical treatment, and hospital stays were independently associated with 30-day mortality. Conclusions: ST11 CRKP payed a dominant role in the process, but the homology of these strains was polymorphic and the advantage clusters would be changed by evolution. Additionally, besides appropriate empirical treatment and hospital stays, ST11 CRKP was independently associated with the 30-day mortality, first reported as we know.

scholarly journals Epidemiology and Clinical Significance of pLVPK-Like Virulence Plasmid in KPC-2-Producing Klebsiella Pneumoniae Infections in A Tertiary Hospital in Eastern China

2020 ◽  
Author(s):  
Min Xu ◽  
Qing Yang ◽  
Yanchao Liu ◽  
Xiao Chen ◽  
Haishen Kong ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Clinical Outcomes ◽  
Susceptibility Testing ◽  
Eastern China ◽  
Multivariable Analysis ◽  
Tertiary Hospital ◽  
Sequence Type ◽  
Virulence Plasmid ◽  
Carbapenem Resistant ◽  
Wide Dissemination

Abstract Background: By acquiring a pLVPK-like virulence plasmid (pVir), Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-kp) evolves to a hypervirulent variant, however, controversies exist. The aim of present study was to determine the prevalence, risk factors and clinical outcomes of patients infected with pVir+-KPC-kp.Methods: Between 2014 and 2018, 662 carbapenem-resistant K. pneumoniae (CRKP) were collected from a tertiary hospital in eastern China. The isolates were subjected to antimicrobial susceptibility testing, multilocus sequence typing and detection of blaKPC, pLVPK-related genetic loci (rmpA, rmpA2, iucA and iroN) to identify pVir+-KPC-kp. The clinical characteristics of pVir+-KPC-kp were retrospectively evaluated.Results: Of the 662 CRKP, 86.6% (573/662) were KPC-kp including 285 (49.7%) pVir+-KPC-kp and 288 (50.3%) pVir--KPC-kp. Notably, the prevalence of pVir+-KPC-kp by year increased remarkably from 2014 (19.5%, 8/41) to 2018 (60.0%, 90/150). Sequence type (ST) 11 was the most predominant ST, accounting for 88.9% of all pVir+-KPC-kp. For the 352 KPC-kp infection cases (186 with pVir+-KPC-kp and 166 with pVir--KPC-kp), multivariable analysis indicated neurosurgery (P =0.002) was independently associated with pVir+-KPC-kp infections. Although patients with pVir+-KPC-kp infections had higher incidence of septic shock (P =0.03), the two groups showed no significant differences in 7-day mortality (P =0.24) or 28-day mortality (P =0.75). Conclusions: A wide dissemination of pVir in ST11 KPC-kp has emerged in our region. Neurosurgery is an independent risk factor for acquisition of pVir+-KPC-kp infections. The mortality rates were similar between patients infected with pVir+-KPC-kp or pVir--KPC-kp, suggesting uncertain impact of pVir in clinical outcomes.

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