Risk factors for carbapenem-resistant Klebsiella pneumoniae infection in a palliative care centre

Introduction
Klebsiella pneumoniae (KP) is a gram-negative bacterium in the Enterobacteriaceae family. It is common among patients receiving palliative care. This study aimed to examine the risk factors for carbapenem-resistant KP (CRKP) infection in our palliative care unit.

Material and methods
This retrospective observational study was conducted in patients found to have KP infection in the palliative care centre of our hospital. Culture results were identified through the microbiological laboratory database. The patients’ demographic and clinical characteristics were obtained from hospital electronic records. The Charlson Comorbidity Index (CCI) was calculated retrospectively for each patient.

Results
The median age of the 88 patients included in the study was 73 years, and 54 (61.4%) were male. The isolated pathogen was CRKP in 55 patients (62.5%). The presence of central venous catheter, tracheostomy, urinary catheter, and intensive care follow-up before admission to the palliative care unit were significantly more common in patients with CRKP-positive cultures. The presence of significant risk factors for carbapenem resistance and univariate logistic regression were used to create a logistic regression model. The results indicated that parenteral nutrition and CCI were independent risk factors that increased the risk of CRKP infection by 3.704 and 1.447 times, respectively.

Conclusions
The prevalence of CRKP is higher in patients receiving parenteral nutritional support. This demonstrates the importance of early transition to enteral nutrition if there is no contraindication. High CCI is a significant risk factor for the development of CRKP infection.