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Epidemiology of bloodstream infections sustained by carbapenem-resistant Klebsiella pneumonia in a large teaching hospital in northern Italy

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Antimicrobial Resistance and Infection Control20154(Suppl 1):P132

https://doi.org/10.1186/2047-2994-4-S1-P132

Published: 16 June 2015

Keywords

  • Teaching Hospital
  • Annual Incidence
  • Klebsiella Pneumoniae
  • Bloodstream Infection
  • Microbiology Laboratory

Introduction

The rapid diffusion of carbapenem-resistant (C-R) Klebsiella pneumoniae (Kp) represents a global concern from both clinical and public health standpoints. In particular, bloodstream infections sustained by C-R Kp are associated with high mortality rates and the treatment of these clinical picture is a major challenge for clinicians.

Objectives

To describe annual incidence of C-R Kp BSI, dating back to the first positive C-R Kp blood culture, in a 1,300-beds teaching hospital in northern Italy.

Methods

We performed a retrospective study at IRCCS AOU San Martino – IST of Genoa, Italy. Between 1 January 2007 and 31 December 2014, overall hospitalizations and hospital patient-days were obtained from the hospital digital archives of patients’ clinical charts. Similarly, numbers of C-R Kp BSI were identified through the computerized microbiology laboratory database. Annual incidences of health-care associated C-R Kp BSI per 10,000 patient-days were calculated. Overall trends in the incidence of Kp BSI were recorded, by including annual incidences of carbapenem-susceptible (C-S) Kp BSI. Finally, 30-day survivals of both C-R and C-S Kp BSI were estimated.

Results

From 2007 to 2014, we identified 511 episodes of Kp BSI, 349 of which caused by C-R Kp (68.3%). The overall incidence of C-R Kp BSI during the seven-year study period was 0.92/10,000 patient-days, with a peak of 1.77/10,000 patient-days in 2014. The highest annual incidences were registered in intensive care units, with a peak of 22.01 C-R Kp BSI/10,000 patient-days in 2012. The annual incidence of C-S Kp BSI remained steady throughout the study period. 30-day survival was significantly lower in C-R patients than C-S patients (Log-rank p = 0.002).

Conclusion

In our hospital we observed a dramatic increase in the incidence of C-R Kp BSI occurred from 2009 to 2014. More efforts might be necessary to tackle the worrying C-R Kp diffusion in our hospital. Because of the dramatic shortage in antibiotics active against C-R Kp, further improvements in our infection-control practises are also of paramount importance to limit the high number of deaths due to C-R Kp BSI.

Disclosure of interest

None declared.

Authors’ Affiliations

(1)
University of Genoa, Genoa, Italy
(2)
IRCCS AOU San Martino - IST, San Martino, Italy

Copyright

© Alicino et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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