Higher Prevalence of Klebsiella pneumoniae Extended-Spectrum beta-Lactamase in Patients on Renal Replacement Therapy.
10.3346/jkms.2013.28.8.1187
- Author:
Hyang Lim LEE
1
;
Dong Hee WHANG
;
Dong Won PARK
;
Young Jin LEE
;
Yeong Hoon KIM
;
Ho Jun CHIN
;
Suhnggown KIM
;
Ho Seok KOO
Author Information
1. Department of Internal Medicine, Seoul Metropolitan Bukbu Hospital, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Klebsiella pneumoniae;
Extended-Spectrum beta-Lactamase;
Dialysis
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Female;
Humans;
Kaplan-Meier Estimate;
Kidney Failure, Chronic/*microbiology/therapy;
Klebsiella Infections/*epidemiology/microbiology/mortality;
Klebsiella pneumoniae/*enzymology/isolation & purification;
Male;
Middle Aged;
Odds Ratio;
Pneumonia/diagnosis/*epidemiology/microbiology;
Prevalence;
Proportional Hazards Models;
Renal Replacement Therapy;
Retrospective Studies;
Risk Factors;
Serum Albumin/analysis;
beta-Lactamases/*metabolism
- From:Journal of Korean Medical Science
2013;28(8):1187-1193
- CountryRepublic of Korea
- Language:English
-
Abstract:
The prevalence of antibiotic resistance is higher in patients undergoing renal replacement therapy (RRT) than in patients who did not undergo RRT. We investigated the presence of KP (Klebsiella pneumoniae) in patients who underwent RRT. All data were collected retrospectively by accessing patient medical records from 2004 to 2011 for the culture results of all patients who were positive for KP. We grouped the patients by the presence of extended-spectrum beta-lactamase (ESBL) into a KP ESBL(-) group (KP[-]) and a KP ESBL(+) group (KP[+]). In total, 292 patients (23.1%) were in the KP(+) group, and 974 patients (76.9%) were in the KP(-) group. A greater percentage of KP(+) was found in patients who underwent RRT (7.5%) than in patients who did not undergo RRT (3.2%) (OR, 2.479; 95% CI,1.412-4.352). A Cox's hazard proportional model analysis was performed, and for patients with pneumonia, the risk of KP(+) was 0.663 times higher in patients who had lower albumin levels, 2.796 times higher in patients who had an inserted Levin tube, and 4.551 times higher in patients who underwent RRT. In conclusion, RRT can be a risk factor for KP(+) in patients with pneumonia.
