Risk Factors and Outcomes of Community-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection in Elderly Patients

• Published in: Antibiotics (Basel) Vol. 13; no. 3; p. 282
• Main Authors: Chen, Yen-Chou, Tsai, I-Ting, Lai, Chung-Hsu, Lin, Kuo-Hsuan, Hsu, Yin-Chou
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 20.03.2024; MDPI
• Subjects: antibiotic resistance; Antibiotics; Bacterial diseases; carbapenem-resistant; Carbapenems; Disease; elderly; Emergency medical care; Emergency medical services; Health care facilities; Hospitals; Immune response; Infections; Klebsiella; Klebsiella pneumoniae; Mortality; Older people; outcomes; Pathogens; Penicillin; Pneumonia; Regression analysis; Respiratory failure; Risk factors; Sepsis; Septic shock; Ventilators; carbapenem-resistant; risk factors; antibiotic resistance; outcomes; elderly; Klebsiella pneumoniae
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics13030282

The increasing prevalence of carbapenem-resistant (CRKP) infections is a global concern. Elderly patients have a diminished immune response and functional reserve, and are thus more vulnerable to bacterial infection. This study aimed to investigate the risk factors and outcomes in elderly patients with community-acquired CRKP infections. We performed a retrospective cohort study in a tertiary medical center between 1 January 2021, and 31 December 2021. All elderly patients who visited the emergency department during this period with culture-positive were enrolled, and their baseline demographics, laboratory profiles, management strategies, and outcomes were recorded and analyzed. We identified 528 elderly patients with infection, and the proportion of patients with CRKP infection was 10.2% (54/528). Recent intensive care unit (ICU) admission and prior carbapenem use are independent risk factors for CRKP infection in elderly patients. Compared to patients with carbapenem-sensitive infection, those with CRKP infection had a significantly higher risk of adverse outcomes, including ICU care, respiratory failure, septic shock, and 90-day mortality. CRKP infection was also identified as an independent risk factor for 90-day mortality. Clinicians should be aware of the increasing prevalence of CRKP infections in elderly patients and judiciously choose appropriate antibiotics for these patients.