Abstract Objective To identify risk factors for carbapenem-resistant Klebsiella pneumoniae (CRKP) infection and death in hospitalized children in pediatric hospitals, and to provide a basis for the prevention and control of such infection. Methods This is a matched case-case-control study. The medical data of 81 children with CRKP infection and 81 children with carbapenem-sensitive Klebsiella pneumoniae (CSKP) infection who were hospitalized in Kunming Children's Hospital from January 2019 to October 2021 were retrospectively analyzed. A total of 162 children without CRKP or CSKP infection were enrolled as the control group. The association of underlying disease, previous hospitalization exposure, and current hospitalization exposure with CRKP infection and death was identified. Results Compared with the control group, there was a higher correlation between the history of hospitalization in the past 3 months and CRKP and CSKP infections (OR=14.25 and 10.07 respectively, P<0.01). The use of carbapenem in the past 3 months (OR=16.54, P<0.01) and central venous catheterization during the current hospitalization (OR=33.03, P<0.01) were risk factors for CRKP infection. The use of carbapenem in the past 3 months (OR=28.33, P<0.01) and empirical antibiotic use during the current hospitalization (OR=14.5, P<0.01) were risk factors for death of the children with CRKP infection. Conclusions The history of hospitalization and the history of treatment with carbapenems in the past 3 months and invasive procedure after admission are leading influencing factors for CRKP infection and prognosis. It is necessary for pediatric hospitals to conduct CRKP screening on admission, standardize antibiotic use, and strengthen nosocomial infection surveillance, so as to decrease the incidence of CRKP infection. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(9): 1008-1013
DAI Lu,LI Feng,JIANG Hong-Chao et al. Risk factors for nosocomial infection of carbapenem-resistant Klebsiella pneumoniae in children: a single-center matched case-case-control study[J]. CJCP, 2022, 24(9): 1008-1013.
DAI Lu,LI Feng,JIANG Hong-Chao et al. Risk factors for nosocomial infection of carbapenem-resistant Klebsiella pneumoniae in children: a single-center matched case-case-control study[J]. CJCP, 2022, 24(9): 1008-1013.
Kaye KS, Harris AD, Samore M, et al. The case-case-control study design: addressing the limitations of risk factor studies for antimicrobial resistance[J]. Infect Control Hosp Epidemiol, 2005, 26(4): 346-351. PMID: 15865269. DOI: 10.1086/502550.
Gómez Rueda V, Zuleta Tobón JJ. Risk factors for infection with carbapenem-resistant Klebsiella pneumoniae: a case-case-control study[J]. Colomb Med (Cali), 2014, 45(2): 54-60. PMID: 25100889. PMCID: PMC4123582.
Logan LK, Nguyen DC, Scaggs Huang FA, et al. A multi-centered case-case-control study of factors associated with Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae infections in children and young adults[J]. Pediatr Infect Dis J, 2019, 38(5): 490-495. PMID: 30169484. PMCID: PMC6395555. DOI: 10.1097/INF.0000000000002176.
