A hospital-based matched case–control study to identify risk factors for clinical infection with OXA-48-producing Klebsiella pneumoniae in rectal carriers

SUMMARYAsymptomatic colonisation of the gastrointestinal tract by carbapenemase-producing Enterobacteriaceae is an important reservoir for transmission, which may precede infection. This retrospective observational case–control study was designed to identify risk factors for developing clinical infection with OXA-48-producing Klebsiella pneumoniae in rectal carriers during hospitalisation. Case patients (n = 76) had carbapenemase-producing K. pneumoniae (CPKP) infection and positive rectal culture for CPKP. Control patients (n = 174) were those with rectal colonisation with CPKP but without CPKP infection. Multivariate analysis identified the presence of a central venous catheter (OR 4·38; 95% CI 2·27–8·42; P = 0·008), the number of transfers between hospital units (OR 1·27; 95% CI (1·06–1·52); P < 0·001) and time at risk (OR 1·02 95% CI 1·01–1·03; P = 0·01) as independent risk factors for CPKP infection in rectal carriers. Awareness of these risk factors may help to identify patients at higher risk of developing CPKP infection.

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Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies

Infection Control and Hospital Epidemiology ◽

10.1086/592412 ◽

2008 ◽

Vol 29 (12) ◽

pp. 1099-1106 ◽

Cited By ~ 528

Author(s):

Gopi Patel ◽

Shirish Huprikar ◽

Stephanie H. Factor ◽

Stephen G. Jenkins ◽

David P. Calfee

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Case Control Study ◽

Patient Survival ◽

Case Control ◽

Factors Associated ◽

Carbapenem Resistant ◽

Matched Case ◽

The Impact ◽

Control Study

Background.Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen.Objective.To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection.Setting.Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City.Design.Two matched case-control studies.Methods.In the first matched case-control study, case patients with carbapenem-resistant K. pneumoniae infection were compared with control patients with carbapenem-susceptible K. pneumoniae infection. In the second case-control study, patients who survived carbapenem-resistant K. pneumoniae infection were compared with those who did not survive, to identify risk factors associated with mortality among patients with carbapenem-resistant K. pneumoniae infection.Results.There were 99 case patients and 99 control patients identified. Carbapenem-resistant K. pneumoniae infection was independently associated with recent organ or stem-cell transplantation (P = .008), receipt of mechanical ventilation (P = .04), longer length of stay before infection (P = .01), and exposure to cephalosporins (P = .02) and carbapenems (P < .001). Case patients were more likely than control patients to die during hospitalization (48% vs 20%; P < .001) and to die from infection (38% vs 12%; P < .001). Removal of the focus of infection (ie, debridement) was independently associated with patient survival (P = .002). The timely administration of antibiotics with in vitro activity against carbapenem-resistant K. pneumoniae was not associated with patient survival.Conclusions.Carbapenem-resistant K. pneumoniae infection is associated with numerous healthcare-related risk factors and with high mortality. The mortality rate associated with carbapenem-resistant K. pneumoniae infection and the limited antimicrobial options for treatment of carbapenem-resistant K. pneumoniae infection highlight the need for improved detection of carbapenem-resistant K. pneumoniae infection, identification of effective preventive measures, and development of novel agents with reliable clinical efficacy against carbapenem-resistant K. pneumoniae.

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A hospital-based matched case–control study to identify clinical outcome and risk factors associated with carbapenem-resistant Klebsiella pneumoniae infection

BMC Infectious Diseases ◽

10.1186/1471-2334-13-80 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 66

Author(s):

Luci Correa ◽

Marines Dalla Valle Martino ◽

Itacy Siqueira ◽

Jacyr Pasternak ◽

Ana Cristina Gales ◽

...

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Clinical Outcome ◽

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Carbapenem Resistant ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Risk Factors and Outcomes Associated with Acquisition of Colistin-Resistant KPC-Producing Klebsiella pneumoniae: a Matched Case-Control Study

Journal of Clinical Microbiology ◽

10.1128/jcm.02301-09 ◽

2010 ◽

Vol 48 (6) ◽

pp. 2271-2274 ◽

Cited By ~ 73

Author(s):

O. Zarkotou ◽

S. Pournaras ◽

E. Voulgari ◽

G. Chrysos ◽

A. Prekates ◽

...

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Case Control Study ◽

Case Control ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Risk factors for colonization with carbapenemase-producing Klebsiella pneumoniae in hospital: A matched case-control study

American Journal of Infection Control ◽

10.1016/j.ajic.2014.05.028 ◽

2014 ◽

Vol 42 (9) ◽

pp. 1006-1008 ◽

Cited By ~ 8

Author(s):

Carlo Gagliotti ◽

Stefano Giordani ◽

Vincenzo Ciccarese ◽

Agostino Barozzi ◽

Antonio Giovinazzi ◽

...

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Case Control Study ◽

Case Control ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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Faculty Opinions recommendation of Risk factors of carbapenem-resistant Klebsiella pneumoniae infections: a matched case control study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1113092.569076 ◽

2008 ◽

Author(s):

Kenneth Thomson

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Case Control Study ◽

Case Control ◽

Carbapenem Resistant ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

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The Risk Factors for Pulmonary Tuberculosis Incidence in Ghana: A Small Matched Case-control Study

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2020/v4i130137 ◽

2020 ◽

pp. 14-23

Author(s):

Michael Boah ◽

Daniel Adjei Amporfro ◽

Timothy Adampah ◽

Stephen Bordotsiah ◽

Baiming Jin ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Conditional Logistic Regression ◽

Case Control ◽

Northern Ghana ◽

Monthly Income ◽

Matched Case ◽

Independent Risk Factors ◽

Matched Case Control Study ◽

Control Study

Aims: Knowing the risk factors for tuberculosis (TB) opens up avenues for identifying target groups for intensified case finding. We aimed to identify the risk factors for pulmonary TB (PTB) incidence in a rural district in northern Ghana. Study Design: A matched case-control study. Place and Duration of Study: The Kassena Nankana West District of the Upper East Region of Ghana, between February 2019 and March 2019. Methodology: This study was conducted in 4 public health facilities. Cases were newly confirmed PTB patients aged 15 years or over, controls were age and sex matched outpatients. A pre-tested questionnaire collected information on a range of possible risk factors from participants. Conditional logistic regression identified independent risk factors for PTB incidence in a multivariable model at 95% confidence level. Results: The analysis included 174 cases and controls. Multivariable analysis showed that the risk of PTB was increased with low household monthly income (AOR=3.45; 95% CI: 1.08-10.97; P=.03), smoking (AOR=2.69; 95% CI: 1.13-6.43; P=.02) as well as household exposure to a known TB case (AOR=2.57; 95% CI: 1.08-6.10; P=.03). Conclusion: Low household monthly income, smoking, and household exposure to a known TB case were independent risk factors for PTB incidence. These factors can be used to actively screen for PTB in the population.

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