Investigation of carbapenem resistant Klebsiella pneumoniae colonization in rectal swab samples of patients followed in intensive care units

Klebsiella pneumoniae is a Gram negative, immobile, non-spore and encapsulated bacterium belonging to the Enterobacteriaceae family. Since it is a bacterium found in the upper respiratory tract and faecal flora in humans, it emerges as an opportunistic pathogen in unfavorable conditions. So, it is one of the important agents for causing nosocomial infections. It is known that hospitilisation in intensive care or prolonged hospitilisation in other clinics, immune deficiency, invasive interventions and multiple and long-term antibiotic usage facilitate the formation of resistant strains. For prevention of Carbapenem-Resistant Klebsiella pneumonaie (CRKP) infections, it is recommended to screen positive rectal swabs and isolate positive patients. In this study we collected the data of rectal swab samples from patients who hospitalized 72 hours and more in ICU units in Düzce University Health Application and Research Center between November 2014 and November 2015 were analyzed retrospectively. This study may be a guide for establishing the relation between patient risk factors and KDKP colonization and taking steps for preventation. A total of 287 rectal swab specimens from 190 patients routinely referred to the microbiology laboratory were inoculated on Eosine Methylen Blue (EMB) agar and 5% sheep blood agar and incubated at 36 °C. The identification of Gram negative bacterial growth in the medium was carried out by conventional methods and / or by Vitek 2 automated systems. Imipenem, meropenem and ertapenem susceptibility of strains detected by disc diffusion method and resistant strains were evaluated by agar gradient test and / or vitek 2 automated system. Data of patients were determined by data recorded in hospital automation system and / or file scanning. In our study, blood transfusion and total parenteral nutrition (TPN) applications and glycopeptide group antibiotic use were found as important risk factors for CRKP colonization. Central venous catheter application poses a separate risk for neonatal colonization. Necessary precautions should be taken to prevent resistant bacterial colonization, patient isolation and trainings should be done regularly.