Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, P. O. Box 731, Bisha, 67614, Saudi Arabia.
Sci Rep. 2023 Jul 19;13(1):11626. doi: 10.1038/s41598-023-38871-7.
Over the last decades, the prevalence of multidrug-resistant (MDR) Klebsiella pneumoniae in clinical settings has increased progressively. This study determined the prevalence and risk factors associated with MDR K. pneumoniae infection among hospitalized patients in a referral hospital located in southern Saudi Arabia. A prospective cross-sectional study was conducted in King Abdullah Hospital from April 2021 to March 2022. K. pneumoniae (n = 211) bacteria were recovered from clinical samples of adult patients and examined for antibiotic susceptibility. Univariate and multivariate logistic regressions were applied to determine the factors associated with MDR K. pneumoniae infection. MDR K. pneumoniae strains was found in 66.8% (142/211) of the patients. Among MDR K. pneumoniae, the highest resistance rate was determined for ampicillin (100%), cefuroxime (97.9%), ceftriaxone (94.3%), and aztreonam (92.2%). The lowest resistance rate was determined for colistin (16.3%), and tigecycline (6.4%). Further, the patients' gender, age group, intensive care unit (ICU) admission, invasive medical devices, and chronic illness were found to be significantly associated with MDR K. pneumoniae infection. The independent risk factors associated with MDR K. pneumoniae infection were the male gender (adjusted odds ratio [AOR] 2.107, 95% confidence interval CI 1.125‒3.945, p = 0.02), patients ≥ 65 years of age (AOR 1.905; CI 1.003‒3.616, p = 0.049), ICU admission (AOR 1.963; CI 1.033‒3.732, p = 0.04), diabetes (AOR 1.95; CI 1.02‒3.727, p = 0.043) and chronic obstructive pulmonary disease (AOR 7.172; CI 1.557‒33.032, p = 0.011). The study offered a vision of MDR K. pneumoniae infection in our setting and provided essential indications for further studies that may lead to the prevention and reduction of MDR bacteria.
在过去的几十年中，临床环境中多药耐药（MDR）肺炎克雷伯菌的流行率逐渐增加。本研究旨在确定位于沙特阿拉伯南部的一家转诊医院住院患者中 MDR 肺炎克雷伯菌感染的流行率和相关危险因素。2021 年 4 月至 2022 年 3 月，在阿卜杜拉国王医院进行了一项前瞻性的横断面研究。从成年患者的临床样本中分离出肺炎克雷伯菌（n=211）并检测其抗生素敏感性。应用单因素和多因素逻辑回归分析确定与 MDR 肺炎克雷伯菌感染相关的因素。在 211 名患者中，发现 66.8%（142/211）的患者存在 MDR 肺炎克雷伯菌。在 MDR 肺炎克雷伯菌中，对氨苄西林（100%）、头孢呋辛（97.9%）、头孢曲松（94.3%）和氨曲南（92.2%）的耐药率最高。对黏菌素（16.3%）和替加环素（6.4%）的耐药率最低。此外，患者的性别、年龄组、重症监护病房（ICU）入院、侵入性医疗设备和慢性疾病与 MDR 肺炎克雷伯菌感染显著相关。与 MDR 肺炎克雷伯菌感染相关的独立危险因素是男性（调整后的优势比[OR] 2.107，95%置信区间[CI] 1.125-3.945，p=0.02）、年龄≥65 岁（OR 1.905；CI 1.003-3.616，p=0.049）、ICU 入院（OR 1.963；CI 1.033-3.732，p=0.04）、糖尿病（OR 1.95；CI 1.02-3.727，p=0.043）和慢性阻塞性肺疾病（OR 7.172；CI 1.557-33.032，p=0.011）。本研究提供了我们研究环境中 MDR 肺炎克雷伯菌感染的情况，并为进一步研究提供了重要的依据，这些研究可能有助于预防和减少耐药菌的产生。
