Increasing risk of infection in patients staying in the same room with CRKP infection/colonization:a case-control study bused on ICU
OBJECTIVE To study whether staying in the same room with carbapenem resistant Klebsiella pneu-moniae(CRKP)infected/colonized patients increase the risk of infection in ICU.METHODS A case-case-control study was conducted in the ICU ward of West Hospital of Sichuan university from Jan.2016 to Dec.2018.Two Case-control studies were included,the case group of study 1 was patients with hospital-acquired infections of CRKP,and the control group was patients without CRKP.The case group of study 2 was patients with hospital-acquired infections of carbapenem sensitive Klebsiella pneumoniae(CSKP),and the control group was the pa-tients without CRKP and CSKP.Binary logistic regression was used to analyze the influencing factors of the two case groups for CRKP and CSKP respectively.RESULTS A total of 2 269 patients were included as study subjects,with 106 cases in the case group of study 1 and 52 cases in the case group of study 2.Same-room exposure was an independent risk factor for CRKP hospital-acquired infections(OR=2.037,95％CI 1.277-3.251,P=0.003);Other independent risk factors for carbapenem resistance in Klebsiella pneumoniae included APACHE Ⅱ score(OR=1.029,95％CI:1.001-1.057,P=0.042),tigecycline(OR=1.944,95％CI 1.245-3.034,P=0.003),parenteral nutrition(OR=1.998,95％CI:1.052-3.792,P=0.034),intestinal colonization(OR=4.160,95％CI 2.702-6.407,P＜0.001),pancreatitis(OR=1.807,95％CI 1.125-2.902,P=0.014)and nebulization(OR=2.082,95％CI 1.232-3.520,P=0.006).CONCLUSION The same-room exposure was an independent risk factor for CRKP hospital-acquired infections,and specific management measures and strategies should be for-mulated for preventable and controllable risk factors in order to carry out the prevention and control of CRKP in a more targeted,scientific and effective manner.
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