Major articleRisk factors for developing clinical infection with carbapenem-resistant Klebsiella pneumoniae in hospital patients initially only colonized with carbapenem-resistant K pneumoniae
Section snippets
Methods
Soroka University Medical Center is a 1,000-bed acute tertiary care university teaching hospital with more than 85,000 admission-years, serving a population of more than 500,000 people in southern Israel. To control the nosocomial dissemination of CRKP, since May 2007 our institution has performed active surveillance cultures (using rectal cultures) in patients admitted from other institutions and/or nursing homes, in selective high-risk wards such as intensive care units, and in patients who
Risk factor analysis: CRKP-RC group versus CRKP-IN group
A total of 464 patients with CRKP colonization (70% male) were identified between May 2007 and January 2010 and had records for review. Of these patients, 42 (9%) developed CRKP infection. The median age was 72.5 years (range, 21-95 years) in the CRKP-RC group and 72 years (range, 19-91 years) in the CRKP-IN group. The total CRKP-IN incidence density was 1.57 per 10,000 patient-days. The sources of infection were urinary tract infection (57.5%), ventilator-associated pneumonia (30%), and
Discussion
To examine the acquisition and dissemination of CRKP, we conducted 2 retrospective matched case-control studies. The first CRKP-RC versus control group study aimed to identify the risk factors for acquisition of CRKP colonization in our institution. Considering that CRKP-colonized patients were widely distributed all around the hospital and that a number of cases were also identified by active surveillance at the time of hospital admission (community-acquired), assessment of predictors for CRKP
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Conflict of interest: None to report.