377. Evaluation of Risk Factors for Catheter Related Urinary Tract Infections caused by Carbapenem Resistant Klebsiella pneumonia
Session: Poster Abstract Session: HAI: MDRO-GNR/Emerging Resistant Bacterial Pathogens
Thursday, October 5, 2017
Room: Poster Hall CD
Posters
  • IDWeek CRKP CRUTI poster 2017.pdf (472.5 kB)
  • Background: Antimicrobial resistance is an emerging problem. The rate of carbapenem resistant Klebsiella isolates was progressively increased in recent years. The aim of this study was to evaluate risk factors for catheter related urinary tract infections (CR-UTI) caused by carbapenem resistant Klebsiella pneumonia.

    Methods: In this study, CR-UTIs between January 2014 and April 2017 were evaluated retrospectively. All patients with nosocomial CR-UTI caused by K. pneumonia was included to the study. Only the first isolated K. pneumonia had recorded for each patient. Patients with CR-UTI by CRKP were defined as study group, carbapenem susceptible K. pneumonia as control (CSKP). Comorbidities and risk factors were compared between the two groups.

    Results: Among 122 patients with CR-UTI caused by K. pneumonia, 66 were female (54%), mean age was 69±20.2 years, mean hospital stay 65.6 ± 54.5 days. Of patients, 93% were followed in intensive care unit (ICU). Mortality rate was 51%, 30 days mortality 66%. Among K. pneumonia isolates, CSKP was detected in 66 patients (%54) and CRKP in 56 patients (46%). ESBL rate was 81%, colistin resistance 16.4%. In CRKP group, ESBL rate was significantly higher than CSKP group (96% versus 68%) (p=0.000) (OR=12.6, 95% CI: 2.80-56.66). Colistin resistance also was significantly higher in CRKP group (32.1% versus 5.1%, p=0.006) (OR=8.7, 95% CI: 1.71-44.68). Age and gender were not different in the two groups (p>0.05). In CRKP group, mortality rate was 3.19 times higher than CSKP group (p=0.002), but 30 days mortality was similar (p>0.05). Total length of stay in hospital was not different (p>0.05) but length of stay in ICU (p=0.036) and length of stay before infection (p= 0.049) was longer in CRKP group. There was no significant difference in terms of comorbidities (p>0.05, for each). In univariate analyses, central venous catheter (p=0.044, OR: 2.43, 95% CI: 1.009-5.88) and total parenteral nutrition (TPN)(p=0.001, OR: 4.35, 95% CI: 1.83-10.31) were risk factors for CRKP. In multivariate analyses, TPN was found independent risk factor for CRKP (p=0.001, OR: 4.88, 95% CI: 1.87-12.72).

    Conclusion: We detected that mortality rate was higher; length of stay in ICU and length of stay before infection were longer in patients with CR-UTI caused by CRKP. The ESBL rate was also high in CRKP group. TPN was found independent risk factor for acquiring CRKP.

    Cigdem Ataman Hatipoglu, Assoc. Prof.1, Cemal Bulut, Prof.2, Sebnem Erdinc, Assoc. Prof.3, Gunay Ertem, Assoc. Prof.3, Sami Kinikli, MD1, Necla Tulek, Prof.3, Bedia Dinc, Assoc. Prof.4, Esra Kaya Kilic, MD. PhD.3 and Meliha Cagla Sonmezer, MD3, (1)Infectious Diseases and Clinical Microbiology, Medical Sciences University, Ankara Training and Research Hospital, Ankara, Turkey, (2)Infectious Disease and Clinical Microbiology, Medical Sciences University, GATA Training and Research Hospital, Ankara, Turkey, (3)Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey, (4)Clinical Microbiology, Medical Sciences University, Ankara Training and Research Hospital, Ankara, Turkey

    Disclosures:

    C. Ataman Hatipoglu, None

    C. Bulut, None

    S. Erdinc, None

    G. Ertem, None

    S. Kinikli, None

    N. Tulek, None

    B. Dinc, None

    E. Kaya Kilic, None

    M. C. Sonmezer, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 4th with the exception of research findings presented at the IDWeek press conferences.