BACKGROUD To analyze the risk factors for acquiring multi-drug resistant Klebsiella pneumoniae (MDR-Kpn).
METHODS Data were collected from patients who were admitted into a tertiary teaching hospital in China from January 2018 to October 2020. Sensitive Klebsiella pneumoniae (Kpn) was detected in 82 patients. After a period of treatment, 41 patients were detected with MDR-Kpn, and they were designed as the MDR-Kpn group. Another 41 patients always detected with sensitive Klebsiella pneumoniae were assigned to the sensitive Kpn group. The baseline characteristics and clinical parameters were compared between these two groups. Multivariate logistic regression analysis were conducted to determine the risk factors for acquiring MDR-Kpn.
RESULTS The proportion of sex, history of smoking and department distribution had no significant differences between these two groups. However, the patients with chronic pulmonary diseases and neurological disorders were more likely to acquire MDR-Kpn. It also showed longer hospital stay before the first detection of multi-drug resistant Kpn in MDR-Kpn group than the hospital stay before the last detection of sensitive-Kpn in sensitive Kpn group. Additionally, days of hospitalization, ICU stay, days of drainage tube use, times of sputum suction, days of foley catheter use, days of vascular catheter use between the twice detection (it represents the time interval between first detection of sensitive-Kpn to first detection of resistant-Kpn in MDR-Kpn group, and also represents the time interval between first detection of sensitive-Kpn to last detection of sensitive-Kpn in sensitive Kpn group), were higher in MDR-Kpn group. The results showed more categories of antimicrobials in patients of acquiring MDR-Kpn, along with more days of using broad-spectrum cephalosporins, fluoroquinolones and glycylcyclines, compared to non-transition group. Multivariate logistic regression analysis showed that the number of comorbidities, hospital stay before the first detection of multidrug-resistan Kpn (MDR-Kpn group) or last detection of sensitive Kpn (Sensitive group), days of using drainage tube and number of antimicrobial categories between the two detection were independent risk factors of acquiring multidrug-resistance for Kpn.
CONCLUSION: The number of comorbidities, the hospital stay, the number of antimicrobial categories, and days of using drainage tube were independent risk factors for acquiring MDR-Kpn.