Carbapenem-resistant Klebsiella pneumoniae outbreak in a COVID-19 intensive care unit; a case-control study. (17th November 2022)

• Record Type: Journal Article
• Authors: Ergen, Pınar; Koçoğlu, M. Esra; Nural, Müge; Kuşkucu, Mert Ahmet; Aydin, Özlem; İnal, Ferda Y.; Öztürk, Hande; Üçişik, Ayşe C.; Çaşkurlu, Hülya; Güneysu, Büşra; Yildirim, Büşra; Midilli, Kenan; Çağ, Yasemin; Arslan, Ferhat; Vahaboglu, Haluk
• Is Part Of: Journal of chemotherapy. Volume 34:Number 8(2022)
• Page Start: 517
• Page End: 523
• Publication Date: 2022-11-17
• Subjects: Klebsiella pneumoniae -- Carbapenemases -- microbial drug resistance -- COVID-1 -- retrospective studies -- risk factors; Chemotherapy -- Periodicals; Drug Therapy -- Periodicals; 615.58
• DOI: 10.1080/1120009X.2022.2064698
• Languages: English
• ISSNs: 1120-009X

Abstract

Abstract: We analysed a carbapenem-resistant Klebsiella pneumoniae (CRKP) outbreak in the coronavirus disease (COVID) ICU. We retrospectively collected data from ICU records. We identified 25 cases between 12 November 2020 and 19 December 2020, and compared them to 42 controls present in the ICU during the same period. The presence of a femoral haemodialysis catheter was strongly associated with invasive CRKP infections (cases, 9 [36%]; controls, 0 [0%]; odds ratio [OR] 95% confidence intervals [CIs], 21 (5; 89)). We found a significant association between old age and CRKP infection with adverse outcomes. Sequence analysis revealed three distinct carbapenemase genes: bla NDM-1, bla OXA-48 and bla KPC-2 . We launched rectal swab sampling upon admission to the ICU, cohorted colonized patients and cases and conducted an intensive training programme for newly employed staff. This study revealed that the emergence and dissemination of CRKP in COVID ICUs were associated with increased adverse outcomes. The presence of a femoral haemodialysis catheter was a significant risk factor for CRKP infections.