Title : A single center retrospective study on the incidence and clinical outcomes of patients infected with Klebsiella Pneumoniae Carbapenemase (KPC)-producing klebsiella pneumoniae
Abstract:
Introduction: Currently, one of the most significant nosocomial pathogens is Klebsiella pneumoniae strains that produce carbapenemase, in fact it is one of the most prevalent carbapenemase genes worldwide. Its rise also become a major global public health concern, and the best course of therapy is yet unknown.
Methodology: This was a descriptive cross-sectional study which utilized retrospective chart review of patients who were admitted to a tertiary hospital for Klebsiella Pneumoniae Carbapenemase (KPC)-Producing Klebsiella Pneumoniae infection and treated with culture-guided antimicrobial agents between January 1, 2020 to August 31, 2023. Data on demographic profile, clinical and laboratory findings, and outcomes were collected and summarized.
Results: A total of 88 patients were included with mean age of 53.4 years old and majority of patients were males (69.3%). The most common bacterial cultured site was respiratory (71.6%). The most common signs and symptoms were fever/chills (100.0%) and cough/colds (86.4%). In terms of antibiotic use, almost half had Cephalosporins (57.9%), Macrolides (54.5%), and Beta lactam + Beta lactamase inhibitor (54.5%). As high as 90.6% of patients had elevated WBC. The mean platelet count was 294.7, mean serum creatinine was 1.9, mean AST was 67.3 and mean ALT was 42.0. As much as 90.9% had abnormal Chest X-ray findings. In terms of antibiotic resistance, the highest prevalence was observed in Ampicillin + sulbactam (100% of 83 samples), Cefotaxime (100% of 54 samples), Ceftazidime (98.6% of 73 samples), Cefuroxime (97.6% of 85 samples), and Ceftriaxone (97.5% of 81 samples). The mean length of stay was 16.9 days and 80.7% had prolonged hospitalization. Mortality rate was 48.9%.
Conclusion: Klebsiella Pneumoniae Carbapenemase (KPC)-Producing Klebsiella Pneumoniae was mostly seen in respiratory cultures. Patients with KPC-producing K. pneumoniae infection mostly had fever/chills and cough/colds. Almost all had elevated WBC and abnormal Chest X-ray findings. Antibiotic resistance was most prevalent in Ampicillin + sulbactam and Cefotaxime. Patients with this condition experience poor clinical outcomes with four-fifths experiencing prolonged hospitalization and half leading to mortality. Given the severity of this condition, strict infection control precautions should be observed and treatment should be guided by antibiotic sensitivity.
