Temporal and structural patterns of extended-spectrum cephalosporin-resistant Klebsiella pneumoniae incidence in Swiss hospitals.

L Renggli, M Gasser, C Plüss-Suard, S Harbarth, A Kronenberg

The Journal of hospital infection 2022 Feb

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Routine surveillance data revealed increasing rates of invasive extended-spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCR-KP) in Switzerland, from 1.3% in 2004 to 8.5% in 2019. The main aim of this study was to understand the causes of this recent trend, specifically to identify predictors affecting the incidence of invasive ESCR-KP infections in Switzerland. A retrospective observational multi-centre study was conducted in 21 Swiss hospitals over a period of 11 years (2009-2019). Potential predictor variables for the incidence of invasive ESCR-KP infections were studied with a multiple linear regression model. In an additional analysis, the overall ESCR-KP incidence (all sample sites) was investigated. An increasing incidence of invasive ESCR-KP infections from 0.01 to 0.04 patients per 1000 bed-days was observed between 2009 and 2019 and confirmed by multiple linear regression analysis (P < 0.01). ESCR-KP incidence was higher in university hospitals (P < 0.01) and in the French-speaking region than in the German-speaking region (P < 0.01). There was no association with antibiotic consumption. Analysing the overall ESCR-KP incidence (all sample sites) revealed high variability between university hospitals, mainly due to a high proportion of patients with screening isolates at Geneva University Hospital (50% of patients with ESCR-KP). The incidence of invasive ESCR-KP infections increased in Switzerland between 2009 and 2019 and was not associated with antibiotic consumption. Our findings indicate that, in this low-incidence setting, structural factors such as the hospital type and the linguistic region play a more important role in relation to ESCR-KP incidence than the hospital's antibiotic consumption. Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Citation

L Renggli, M Gasser, C Plüss-Suard, S Harbarth, A Kronenberg. Temporal and structural patterns of extended-spectrum cephalosporin-resistant Klebsiella pneumoniae incidence in Swiss hospitals. The Journal of hospital infection. 2022 Feb;120:36-42