{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:46Z","timestamp":1788930406866,"version":"build-2803163510"},"reference-count":25,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T00:00:00Z","timestamp":1444608000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2016,1]]},"abstract":"\n OBJECTIVE<\/jats:title>\n \n An improved understanding of carbapenem-resistant\n Klebsiella pneumoniae<\/jats:italic>\n (CRKP) in long-term acute care hospitals (LTACHs) is needed. The objective of this study was to assess risk factors for colonization or infection with CRKP in LTACH residents.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n A case-control study was performed at a university-affiliated LTACH from 2008 to 2013. Cases were defined as all patients with clinical cultures positive for CRKP and controls were those with clinical cultures positive for carbapenem-susceptible\n K. pneumoniae<\/jats:italic>\n (CSKP). A multivariate model was developed to identify risk factors for CRKP infection or colonization.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n A total of 222 patients were identified with\n K. pneumoniae<\/jats:italic>\n clinical cultures during the study period; 99 (45%) were case patients and 123 (55%) were control patients. Our multivariate analysis identified factors associated with a significant risk for CRKP colonization or infection: solid organ or stem cell transplantation (OR, 5.05; 95% CI, 1.23\u201320.8;\n P<\/jats:italic>\n =.03), mechanical ventilation (OR, 2.56; 95% CI, 1.24\u20135.28;\n P<\/jats:italic>\n =.01), fecal incontinence (OR, 5.78; 95% CI, 1.52\u201322.0;\n P<\/jats:italic>\n =.01), and exposure in the prior 30 days to meropenem (OR, 3.55; 95% CI, 1.04\u201312.1;\n P<\/jats:italic>\n =.04), vancomycin (OR, 2.94; 95% CI, 1.18\u20137.32;\n P<\/jats:italic>\n =.02), and metronidazole (OR, 4.22; 95% CI, 1.28\u201314.0;\n P<\/jats:italic>\n =.02).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n \n Rates of colonization and infection with CRKP were high in the LTACH setting, with nearly half of\n K. pneumoniae<\/jats:italic>\n cultures demonstrating carbapenem resistance. Further studies are needed on interventions to limit the emergence of CRKP in LTACHs, including targeted surveillance screening of high-risk patients and effective antibiotic stewardship measures.\n <\/jats:p>\n \n Infect. Control Hosp. Epidemiol.<\/jats:italic>\n 2015;37(1):55\u201360\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/ice.2015.254","type":"journal-article","created":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T17:44:50Z","timestamp":1444671890000},"page":"55-60","source":"Crossref","is-referenced-by-count":57,"title":["The Epidemiology of Carbapenem-Resistant\n Klebsiella pneumoniae<\/i>\n Colonization and Infection among Long-Term Acute Care Hospital Residents"],"prefix":"10.1017","volume":"37","author":[{"given":"John P","family":"Mills","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naasha J","family":"Talati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Alby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,10,12]]},"reference":[{"key":"S0899823X15002548_ref22","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00299-07"},{"key":"S0899823X15002548_ref19","unstructured":"Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE): 2012 CRE Toolkit. Centers for Disease Control and Prevention Web site. http:\/\/www.cdc.gov\/hai\/pdfs\/cre\/CRE-guidance-508.pdf. Accessed July 1, 2015."},{"key":"S0899823X15002548_ref12","doi-asserted-by":"publisher","DOI":"10.1086\/600391"},{"key":"S0899823X15002548_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2011.09.011"},{"key":"S0899823X15002548_ref3","doi-asserted-by":"publisher","DOI":"10.3201\/eid2007.121004"},{"key":"S0899823X15002548_ref11","doi-asserted-by":"publisher","DOI":"10.1086\/669087"},{"key":"S0899823X15002548_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir482"},{"key":"S0899823X15002548_ref2","doi-asserted-by":"publisher","DOI":"10.1086\/605922"},{"key":"S0899823X15002548_ref16","unstructured":"Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Information Supplement. 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