Serdar KALEMCİ, Timur KÖSE, Meltem TAŞBAKAN, Hüsnü PULLUKÇU, Bayram ALİYEV, Fuat KIZILAY, Adnan ŞİMŞİR

Carbapenem-resistant Klebsiella pneumonia infection outbreak in a tertiary urology clinic: analysis of influencing factors with a controlled trial

Background/aim: Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections encountered in urology patients differentiate frominfections caused by other factors, both in respect to prophylaxis and treatment stage, and require a special approach. We aimed toanalyse the predisposing factors and the antibiotherapies for CR-KP infection outbreak in a tertiary urology clinic.Materials and methods: There were 75 patients in the CR-KP positive group (Group I) and 146 patients in the CR-KP negative group(Group II). Analysis of the predisposing factors for CR-KP infection and comparison of the reinfection rate and the antibiotherapies inthe 2 groups were the endpoints.Results: In the first group, age, comorbidity, previous antibiotic use, and nephrostomy tube rates were higher (P = 0.015, P = 0.001, P= 0.004, and P < 0.001, respectively). In the second group, open urological surgery rate, and the proportion of patients presenting withflank pain, lower urinary tract symptoms, and haematuria were higher (P = 0.029, P < 0.001, P < 0.001, and P = 0.007). In the first group,the proportion of patients treated with transurethral bladder tumour resection was higher, whereas, percutaneous nephrolithotomywas higher in the second group (P = 0.045 for both). While hospitalization and Foley catheterization duration were longer in the firstgroup (P < 0.001 for both), double J stent and nephrostomy duration were longer in the second group (P < 0.001 and P = 0.005). Meanleukocyte count at admission was higher in the first group (P < 0.001).Conclusion: Advanced age, comorbidities, previous antibiotic use, and prolonged Foley catheterization duration are predisposing factorsfor this infection in the urology department. Two-week administration of combination antibiotic regimens containing carbapenem wereeffective for the treatment of this infection.

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