From the Journals

Carbapenem-resistant K. pneumoniae occurs in 25% of long-term acute care hospital cultures


 

FROM CLINICAL INFECTIOUS DISEASES

Nearly one-quarter of Klebsiella pneumoniae cultures in a network of U.S. long-term acute care hospitals are resistant to carbapenem, according to Jennifer H. Han, MD, and her associates.

From a sample of 3,846 K. pneumoniae cultures taken from 64 long-term acute care hospitals in 16 states, 946, or 24.6%, of the cultures were carbapenem-resistant, and were taken from 821 patients. Just under 54% of CRKP isolates were taken from a respiratory source, with 37% coming from urine and the remaining 9.4% coming from blood. Nearly all CRKP isolates were resistant to fluoroquinolones, and 59.2% were resistant to amikacin.

Antibiotic Resistance concepts,isolated on white background. MacXever/Thinkstock
Respiratory failure was the most common comorbidity, occurring in nearly 40% of patients with CRKP. Just over 50% of CRKP patients had a central venous catheter, and 64.8% of patients had a tracheostomy. The median age of patients with CRKP was 72.

Of the 16 states where cultures were taken from, California had the highest rate of carbapenem resistance, with 45.5% of K. pneumoniae cultures showing resistance. Other states with high rates of CRKP included South Carolina, Kentucky, and Indiana.

“Given the chronically, critically ill population, with convergence of at-risk patients from multiple facilities, future studies of optimal infection prevention strategies are urgently needed for this setting. In addition, expansion of national surveillance efforts and improved communication between [long-term acute care hospitals] and acute care hospitals will be critical for reducing the continued emergence and dissemination of CRKP across the health care continuum,” Dr. Han and her associates concluded.

Find the full study in Clinical Infectious Diseases (doi: 10.1 LTACHs 093/cid/ciw856)

Recommended Reading

Guidelines for diagnosing TB in adults, children
MDedge Infectious Disease
High levels of flu activity in 10 U.S. states
MDedge Infectious Disease
Streptococcal pneumonia’s resistance to macrolides increasing
MDedge Infectious Disease
Rhinovirus most often caused HA-VRIs in two hospitals
MDedge Infectious Disease
Assay testing accurate in distinguishing bacterial from viral respiratory tract infections
MDedge Infectious Disease
PCV effective against HNIs, pHNIs that require hospitalization in immunized children
MDedge Infectious Disease
Ultrashort course antibiotics may be enough in stable VAP
MDedge Infectious Disease
Childhood PCV program produces overall protection
MDedge Infectious Disease
Flu activity up slightly, but still down from seasonal peak
MDedge Infectious Disease
Don’t delay pneumococcal conjugate vaccine for preterm infants
MDedge Infectious Disease