Trends in the annual incidence of carbapenem-resistant Klebsiella pneumoniae bloodstream infections: a 8-year retrospective study in a large teaching hospital in northern Italy

• Published in: BMC infectious diseases Vol. 15; no. 1; p. 415
• Main Authors: Alicino, Cristiano, Giacobbe, Daniele Roberto, Orsi, Andrea, Tassinari, Federico, Trucchi, Cecilia, Sarteschi, Giovanni, Copello, Francesco, Del Bono, Valerio, Viscoli, Claudio, Icardi, Giancarlo
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 13-10-2015; BioMed Central
• Subjects: Aged; Aged, 80 and over; Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - mortality; Carbapenems - pharmacology; Care and treatment; Epidemiology; Female; Health aspects; Hospital patients; Hospitals, Teaching - statistics & numerical data; Humans; Infectious diseases; Intensive Care Units - statistics & numerical data; Italy - epidemiology; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella Infections - mortality; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - pathogenicity; Male; Middle Aged; Retrospective Studies; Teachers; Italy
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-015-1152-0

Bloodstream infections (BSI) due to carbapenem-resistant (C-R) Klebsiella pneumoniae (Kp) are of global concern from both clinical and public health standpoints. This retrospective study aimed to describe C-R Kp BSI epidemiology in a large teaching hospital in northern Italy.
Between 1 January 2007 and 31 December 2014, annual incidences both of C-R Kp BSI and of carbapenem-susceptible (C-S) Kp BSI were calculated as the number of events per 10,000 patient-days. A Chi square test for linear trend was used to assess the change in the incidence of C-R Kp BSI and C-S Kp BSI over the study period. Crude 30-day mortality rates were provided both for C-R Kp BSI and for C-S Kp BSI.
From 2007 to 2014, we observed 511 episodes of Kp BSI, 349 of which were caused by C-R Kp (68.3 %). The incidence of C-R Kp BSI considerably increased from 0.04/10,000 patient-days in 2007 to 1.77/10,000 patient-days in 2014 (Chi square for trend p < 0.001). The highest incidence of C-R Kp BSI was observed in intensive care units (ICUs), with a peak of 22.01 C-R Kp BSI/10,000 patient-days in 2012. A less marked but significant increase of C-S Kp BSI was also observed (Chi square for trend p = 0.004). Crude 30-day mortality was 36.1 % in patients with C-R Kp BSI and 23.5 % in those with C-S Kp BSI.
During the study period, we observed a dramatic increase in the incidence of C-R Kp BSI in our hospital. More concerted infection-control efforts are needed to contain this alarming C-R Kp diffusion.