Incidência de Klebsiella pneumoniae carbapenamase (KPC), resistente a carbapenêmicos e a polimixina B, no Hospital Estudal Sílvio Avidos (HSA)

Abstract

Carbapenemase producing Klebsiella pneumoniae (KPC) is considered a superbug that has become highly resistant to carbapenem-class antibiotics and polymyxin B. This resistance makes it difficult to treat severe hospital-acquired infections because there are few antibiotics that are effective against KPC. The objective of the present study was to analyze the clinical profile and factors associated with the increase in polymyxin resistant Klebsiella pneumoniae carbapenemase infections. A retrospective study was carried out that included 144 patients admitted to the Silvio Avidos State Hospital who developed infections caused by KPC. The data were collected between January 1, 2022, and May 31, 2024. 64.58% of the patients analyzed had polymyxin B-sensitive KPC infection, with a predominance of male patients (70.96%). And 35.41% had infection with polymyxin B-resistant KPC, with a slight predominance of women (52.94%). The contaminated samples that showed the highest positivity for KPC were urine (42.7%), blood (20.9%) and tracheal aspirate (16.3%). Logistic regression analysis revealed that smokers are 3,794 likely to acquire polymyxin Bresistant KPC infection (p = 0.032; OR: 3,794; 95%CI%) compared to other comorbidities and females have 3,490 (p=0.002; OR: 3,490; 95%CI) more chances than men of KPC infection being resistant to polymyxin B. The analysis also revealed a significant association between polymyxin B resistance and patient improvement (p = 0.049; OR = 0.360; 95%CI), indicating that resistance may be associated with a reduction in the patient's likelihood of improvement and that age also has a negative impact on the patient's prognosis (p= 0.002; OR: 0.958; 95%CI).