Drug resistance of carbapenem-resistant Klebsiella pneumonia colonized in neonates and risk factors of its clonization
10.3760/cma.j.issn.1674-2397.2015.05.003
- VernacularTitle:新生儿碳青霉烯类耐药肺炎克雷伯菌的耐药性及其定植的危险因素分析
- Author:
Yang CAO
;
Jingqiu MAO
;
Dianjun WEI
;
Xin LI
;
Wei CHEN
- Publication Type:Journal Article
- Keywords:
Infant,newborn;
Klebsiella pneumonia;
Carbapenems;
Drug resistance;
Colonization;
Risk factors
- From:
Chinese Journal of Clinical Infectious Diseases
2015;(5):407-412
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study drug resistance of carbapenem-resistant Klebsiella pneumonia ( CRKP) in neonates hospitalized in the neonatal unit , and to identify the risk factors for CRKP colonization in neonates .Methods Totally 108 neonates with Klebsiella pneumonia colonization admitted in Department of Neonates , the Second Hospital of Tianjin Medical University during January 2012 and June 2014 were enrolled in the study , including 23 cases with CRKP colonization ( case group ) and 85 cases with carbapenem-sensitive Klebsiella pneumonia (CSKP) colonization (control group).Chi-square test and fisher exact test were used to compare the differences in resistance to 21 antibiotics between CRKP and CSKP . Univariate analysis and Logistic regression analysis were performed to identify the risk factors for CRKP colonization in neonates .Results All of the CRKP strains were resistant to penicillins , cephalosporins and SMZco, and 95.7% and 87.0% of the CRKP strains were resistant to meropenem and imipenem , respectively.All of the CRKP strains were susceptible to amikacin , gentamicin, ciprofloxacin and tetracycline, but were highly resistant to the rest 16 antibiotics compared with CSKP strains (all P<0.05). Univariate analysis showed that 14 factors were associated with CRKP colonization: exposure to cefoxitin (χ2 =20.053, P<0.01), sputum suction (χ2 =15.817, P<0.01), gastrointestinal decompression (χ2 =10.731, P<0.01), nasogastric feeding (χ2 =15.146, P<0.01), invasive procedure (χ2 =22.572, P<0.01), birth weight (χ2 =6.026, P<0.05), frequency of sampling for CRKP/CSKP (χ2 =18.577, P<0.01), hypertension of pregnancy (χ2 =8.698, P<0.01), premature birth (χ2 =4.904, P<0.05), prenatal hospitalization experience (χ2 =8.396, P<0.01), adequacy for gestational age (χ2 =7.295, P<0.05), gestational age (χ2 =7.294, P<0.05), rupture of membranes (χ2 =9.397, P<0.01), length of hospitalization (χ2 =14.649, P<0.01) and admission to the neonatal intensive care unit (NICU) (OR=11.050, P<0.01).Multivariate Logistic regression analysis showed that hypertension of pregnancy (OR=9.718, P<0.01), rupture of membranes ( <24 h) (OR=6.640, P<0.01) and admission to NICU ( OR=4.119, P<0.05) were independent risk factors for CRKP colonization .Conclusions CRKP strains are highly resistant to most antibiotics .Preventing hypertension of pregnancy and rupture of membranes , and monitoring bacterial resistance in NICU may help to reduce the occurrence of CRKP colonization and dissemination .
