NGHIÊN CỨU ĐẶC ĐIỂM NHIỄM KHUẨN BỆNH VIỆN DO KLEPBSIELLA PNEUMONIA TẠI KHOA HỒI SỨC TÍCH CỰC

Abstract

Objectives: To describe clinical and subclinical characteristics of nosocomial infections caused by K. pneumoniae at the Intensive Care Unit of Bach Mai Hospital 2019 - 2020. Subjects and methods: Prospective cross-sectional descriptive study over 60 patients were diagnosed with nosocomial infections due to K. pneumoniae from 7/2019 to 8/2020. Results: Nosocomial infections due to K. pneumoniae isolated mainly in ventilator-associated pneumonia accounted for 66.67%. The risk of developing K. pneumoniae septic shock in the group of patients with a history of heart failure was 11.87 times higher (95% CI 1.28 – 109.89; p = 0.017) in the group without. Patients with diabetes, taking carbapenem in the previous 30 days, invasive mechanical ventilation ≥ 48 hours, surgery in the previous 30 days increased the risk of carbapenem-resistant K. pneumonia infection by 4.27 times (CI: 1.04 – 17.46; p=0.049); 5.69 times (95%CI: 1.5 – 21.5; p= 0.012); 7.97 times (95%CI: 1.99 – 31.9; p < 0.01); 10.56 times (95% CI: 1.81 – 46.2; p<0.01); respectively, compared with the group without. Multivariate regression analysis showed that a history of carbapenem use in the previous 30 days was an independent risk factor for carbapenem-resistant K. pneumoniae infection with an OR = 6.19 (95% CI: 1.12 – 34.1); p= 0.036). Conclusion: The most common nosocomial infection with Kpenumoniae is ventilator-associated pneumonia. History of carbapenem use, surgery in the previous 30 days, invasive mechanical ventilation for ≥ 48 hours are risk factors for carbapenem-resistant K. pneumoniae and a history of 30-day carbapenem use is an independent risk factor.