Risk factors for carbapenem-resistant Klebsiella pneumoniae infection in a palliative care centre

Pınar Taşar; Busra Akpinar; Omer Karasahin; Goktug Ceylan; Can Sevinc; Hamidullah Uyanık; Sevnaz Sahin

doi:10.5114/pm.2022.123783

eISSN: 2081-2833
ISSN: 2081-0016

Medycyna Paliatywna/Palliative Medicine

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2/2022
vol. 14

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abstract:

Original paper

Risk factors for carbapenem-resistant Klebsiella pneumoniae infection in a palliative care centre

Pınar Tosun Taşar

¹

,

Busra Akpinar

¹

,

Omer Karasahin

²

,

Goktug Ceylan

¹

,

Can Sevinc

³

,

Hamidullah Uyanık

⁴

,

Sevnaz Sahin

⁵

Department of Internal Medicine, Division of Geriatrics, Ataturk University Hospital, Erzurum, Turkey
Infectious Diseases Clinic, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
Department of Internal Medicine, Division of Nephrology, Ataturk University Hospital, Erzurum, Turkey
Department of Microbiology, Clinical Microbiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
Department of Internal Medicine, Division of Geriatrics, Ege University Hospital, Izmir, Turkey

MEDYCYNA PALIATYWNA 2022; 14(2): 83–89

DOI: https://doi.org/10.5114/pm.2022.123783

Online publish date: 2022/12/30

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Introduction
Klebsiella pneumoniae (KP) is a gram-negative bacterium in the Enterobacteriaceae family. It is common among patients receiving palliative care. This study aimed to examine the risk factors for carbapenem-resistant KP (CRKP) infection in our palliative care unit.

Material and methods
This retrospective observational study was conducted in patients found to have KP infection in the palliative care centre of our hospital. Culture results were identified through the microbiological laboratory database. The patients’ demographic and clinical characteristics were obtained from hospital electronic records. The Charlson Comorbidity Index (CCI) was calculated retrospectively for each patient.

Results
The median age of the 88 patients included in the study was 73 years, and 54 (61.4%) were male. The isolated pathogen was CRKP in 55 patients (62.5%). The presence of central venous catheter, tracheostomy, urinary catheter, and intensive care follow-up before admission to the palliative care unit were significantly more common in patients with CRKP-positive cultures. The presence of significant risk factors for carbapenem resistance and univariate logistic regression were used to create a logistic regression model. The results indicated that parenteral nutrition and CCI were independent risk factors that increased the risk of CRKP infection by 3.704 and 1.447 times, respectively.

Conclusions
The prevalence of CRKP is higher in patients receiving parenteral nutritional support. This demonstrates the importance of early transition to enteral nutrition if there is no contraindication. High CCI is a significant risk factor for the development of CRKP infection.

keywords:

Risk factors for carbapenem-resistant Klebsiella pneumoniae infection in a palliative care centre

Pınar Tosun Taşar 1 , Busra Akpinar 1 , Omer Karasahin 2 , Goktug Ceylan 1 , Can Sevinc 3 , Hamidullah Uyanık 4 , Sevnaz Sahin 5

carbapenem-resistant Klebsiella pneumoniae, infection, risk factor, palliative care

Pınar Tosun Taşar

¹

,

Busra Akpinar

¹

,

Omer Karasahin

²

,

Goktug Ceylan

¹

,

Can Sevinc

³

,

Hamidullah Uyanık

⁴

,

Sevnaz Sahin

⁵