Prevalence, clinical profile and resistance patterns of klebsiella pneumoniae nosocomial infections in Paediatric Cardiac Intensive Care Unit Hospital Serdang

S V Ganthirao, Dharenrow and Abdul Ghani, Mohammad Nazrul and Shahrum, Nur Syasya Ilyana (2021) Prevalence, clinical profile and resistance patterns of klebsiella pneumoniae nosocomial infections in Paediatric Cardiac Intensive Care Unit Hospital Serdang. [Project Paper] (Submitted)

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Abstract

Background: Nosocomial infections known as healthcare-associated infections (HAI), are infection(s) acquired during the process of obtaining health care that was not present during the admission. Looking at children with heart conditions, the majority of them rely on cardiac surgery as the transition into adulthood is impeded as many develop complications. In paediatric intensive care units (PICU), NI constitutes complications following cardiac surgery. Multiple surgical wounds and the use of invasive equipment after surgery are the major causes of NI in these individuals. Bloodstream infections are the most common in PICUs, as opposed to adults, where ventilator-associated pneumonia is the most common. Escherichia coli and Klebsiella pneumoniae are two prevalent pathogens that cause NI, with K. pneumoniae being the second most frequent Gram-negative aerobic bacteria. These infections are common in hospitalised patients, and they are frequently treated with β-lactams and other antibiotics. Antibiotic-resistant K. pneumoniae strains, on the other hand, have emerged independently all over the world. In this study, we hope to investigate the prevalence, clinical profiles, and resistance patterns of K. pneumoniae infection in children admitted to PCICU Hospital Serdang. Materials & Methods: A retrospective cross-sectional study was conducted in 2 months among PCICU patients in Hospital Serdang from June 2018 to December 2020. Descriptive analysis and non-parametric analysis were used to present the data and establish any association of statistical significance between independent and dependent variables. Results: Only 49 out of 903 patients in PCICU Hospital Serdang developed nosocomial Klebsiella pneumoniae infection from June 2018 to December 2020. Thus, the prevalence is 5.43%. There were significant associations found between few sociodemographic factors, patient factors and medical interventional factors with the outcome of the infection. The association between gender and respiratory sequelae was significant, where it was more prevalent among males (86.4%, p-value=0.004) than females (45.5%, p-value=0.004). Besides that, infection of K. pneumoniae within the bloodstream has shown to be significantly higher (42.9%) to be associated with death rather than K. pneumoniae infections outside of the bloodstream (8.1%). Another association found was that the use of chest drain showed a significantly lower occurrence at 0% when compared to using other invasive procedures (32.4%) resulting in sepsis and infections. As for the resistance patterns of K. pneumoniae, the majority of PCICU patients were infected with ESBLs (75.5%), followed by non-resistant strains (22.4%). Only 1 patient had an infection of Carbapenem Resistant Klebsiella pneumoniae (CRKP) strains (2.0%). Conclusion: The prevalence of K. pneumoniae nosocomial infection in PCICU Hospital Serdang from 2018 to 2020 is 5.43%. This study showed that there was no significant association between most of the sociodemographic factors, patient factors and medical interventional factors with the outcome of K. pneumoniae nosocomial infections in the PCICU. However, there were significant associations between gender and respiratory sequelae, bloodstream infections and death, and chest drain and sepsis and infections sequelae of K. pneumoniae nosocomial infections. In our findings, the majority of the K. pneumoniae strains were ESBLs followed by non-resistant strains and CRKPs. Keywords: Klebsiella pneumoniae, nosocomial infection, PCICU

Item Type:	Project Paper
Faculty:	Faculty of Medicine and Health Science
Depositing User:	Ms Norafizah Radzuan
Date Deposited:	04 Sep 2023 07:00
Last Modified:	04 Sep 2023 07:00
URI:	http://psaspb.upm.edu.my/id/eprint/1050

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