Статистическая оценка факторов, ассоциированных с полирезистентностью Klebsiella pneumoniae, в условиях многопрофильного стационара
Научно-практический журнал Институт Стоматологии №2 (111), июнь 2026
стр. 105-107
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Аннотация
В статье представлены результаты комплексного статистического анализа приоритетности факторов риска при выделении мультирезистентных штаммов Klebsiella pneumoniae в условиях многопрофильного стационара за период 2022-2024 гг. На основе данных о выделенных 370 изолятах с использованием современных методов статистического и математического анализа проведена оценка семи гипотез о влиянии гендерно-возрастных, медико-демографических, социальных, клинических и организационных факторов на течение ИСМП у пациентов с данным видом полирезистентной микрофлоры. Установлено, что возраст старше 70 лет (OR=1,050 на каждый год), наличие центрального сосудистого катетера (OR=3,070), длительность проведения искусственной вентиляции легких (ИВЛ) более 72 часов (OR=3,820), продолжительная госпитализация свыше 14 дней (OR=4,910) и нахождение в отделении реанимации и интенсивной терапии (OR=2,730) являются статистически значимыми предикторами выделения последующего формирования полирезистентной Klebsiella pneumoniae. Статистически доказано, что наличие полирезистентного штамма у пациента является независимым фактором, увеличивающим летальность пациентов в ОРИТ в 2,310 раза (HR=2,310). Полученные результаты могут служить основой для разработки риск-ориентированных программ эпидемиологического контроля и профилактики инфекций, связанных с оказанием медицинской помощи (ИСМП).
Аннотация (англ)
The article presents the results of a comprehensive statistical analysis of risk factors for the isolation of multidrug-resistant strains of Klebsiella pneumoniae in a multidisciplinary hospital for the period 2022-2024. Based on the data on the identified 370 isolates, seven hypotheses about the influence of demographic, clinical and organizational factors were tested using modern methods of statistical and mathematical analysis. It was found that the age was over 70 years (OR=1.050 for each year), the presence of a central vascular catheter (OR=3.070), the duration of ventilation for more than 72 hours (OR=3.820), prolonged hospitalization for more than 14 days (OR=4.910) and stay in the intensive care unit (OR=2.730) They are statistically significant predictors of the release of the multidrug-resistant Klebsiella pneumoniae. It has been statistically proven that isolation of a multidrug-resistant strain is an independent factor that increases the mortality rate of ICU patients by 2.310 times (HR=2.310). The results obtained can serve as a basis for the development of risk-oriented programs for epidemiological surveillance and prevention of infections related to medical care (IMT).
Ключевые Слова
Klebsiella pneumoniae, мультирезистентность, факторы риска, внутрибольничные инфекции, отделение реанимации и интенсивной терапии (ОРИТ), анализ выживаемости, логистическая регрессия, летальность.
Ключевые Слова (англ)
Klebsiella pneumoniae, multidrug resistance, risk factors, healthcare-associated infections, intensive care unit (ICU), survival analysis, logistic regression, mortality.
Список литературы
1. Miller, W.R., & Arias, C.A. (2024). ESKAPE pathogens: antimicrobial resistance, epidemiology, clinical impact and therapeutics. Nature reviews. Microbiology, 22(10), 598-616.
https://doi.org/10.1038/s41579-024-01054-w.
2. Guoying, W., Guo, Z., Xiaoyu C., Longxiang, X., Hongju, W. (2020) The Characteristic of Virulence, Biofilm and Antibiotic Resistance of Klebsiella pneumoniae. Int J. Environ Res Public Health, 17.
3. K.Paczosa M., Mecsas J., (2016) Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Microbiol Mol Biol Rev, 80(3), 629-661.
4. Salawudeen, A., Raji, Y.E., Jibo, G.G., Desa, M.N.M., Neoh, H.M., Masri, S.N., Di Gregorio, S., & Jamaluddin, T.Z. M.T. (2023). Epidemiology of multidrug-resistant Klebsiella pneumoniae infection in clinical setting in South-Eastern Asia: a systematic review and meta-analysis. Antimicrobial resistance and infection control, 12(1), 142. https://doi.org/10.1186/s13756-023-01346-5.
5. Vink, J., Edgeworth, J., & Bailey, S.L. (2020). Acquisition of MDR-GNB in hospital settings: a systematic review and meta-analysis focusing on ESBL-E. The Journal of hospital infection, 106(3), 419-428. https://doi.org/10.1016/j.jhin.2020.09.006.
6. Itani, R., Khojah, H.M.J., Kibrit, R., Raychouni, H., Shuhaiber, P., Dib, C., Hassan, M., Mukattash, T.L., & El-Lakany, A. (2024). Risk factors associated with multidrug-resistant Klebsiella pneumoniae infections: a multicenter observational study in Lebanese hospitals. BMC public health, 24(1), 2958. https://doi.org/10.1186/s12889-024-20474-0.
7. Magiorakos, A.P., Srinivasan, A., Carey, R.B., Carmeli, Y., Falagas, M.E., Giske, C.G., Harbarth, S., Hindler, J.F., Kahlmeter, G., Olsson-Liljequist, B., Paterson, D.L., Rice, L.B., Stelling, J., Struelens, M.J., Vatopoulos, A., Weber, J.T., & Monnet, D.L. (2012). Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 18(3), 268-281. https://doi.org/10.1111/j.1469-0691.2011.03570.x.
8. Chen, T. A., Chuang, Y. T., & Lin, C. H. (2024). A Decade-Long Review of the Virulence, Resistance, and Epidemiological Risks of Klebsiella pneumoniae in ICUs. Microorganisms, 12(12), 2548. https://doi.org/10.3390/microorganisms12122548;
9. Büyüktuna, S.A., Hasbek, M., Çelik, C., Ünlüsavuran, M., Avcı, O., Baltacı, S., Fırtına Topcu, K., & Elaldı, N. (2020). Yoğun Bakım Ünitesinde Gelişen Klebsiella pneumoniae Enfeksiyonları: Karbapenem Direnci ve Hasta Mortalitesi ile İlgili Risk Faktörleri [Klebsiella pneumoniae Infections in the Intensive Care Unit: Risk Factors Related to Carbapenem Resistance and Patient Mortality]. Mikrobiyoloji bulteni, 54(3), 378-391. https://doi.org/10.5578/mb.69679.
10. Aiesh, B.M., Mousa, N., Jomaa, R., Zouneh, Y., Abuhalima, D., Saifi, M., Namrouti, A., Abutaha, A., Sweileh, M.W., Al-Jabi, S.W., Sabateen, A., & Zyoud, S.H. (2025). Epidemiology, resistance profiles, and risk factors of multidrug-resistant Klebsiella pneumoniae: experience from a low- and middle-income country. BMC infectious diseases, 25(1), 1421. https://doi.org/10.1186/s12879-025-11926-y.
2. Guoying, W., Guo, Z., Xiaoyu C., Longxiang, X., Hongju, W. (2020) The Characteristic of Virulence, Biofilm and Antibiotic Resistance of Klebsiella pneumoniae. Int J. Environ Res Public Health, 17.
3. K.Paczosa M., Mecsas J., (2016) Klebsiella pneumoniae: Going on the Offense with a Strong Defense. Microbiol Mol Biol Rev, 80(3), 629-661.
4. Salawudeen, A., Raji, Y.E., Jibo, G.G., Desa, M.N.M., Neoh, H.M., Masri, S.N., Di Gregorio, S., & Jamaluddin, T.Z. M.T. (2023). Epidemiology of multidrug-resistant Klebsiella pneumoniae infection in clinical setting in South-Eastern Asia: a systematic review and meta-analysis. Antimicrobial resistance and infection control, 12(1), 142. https://doi.org/10.1186/s13756-023-01346-5.
5. Vink, J., Edgeworth, J., & Bailey, S.L. (2020). Acquisition of MDR-GNB in hospital settings: a systematic review and meta-analysis focusing on ESBL-E. The Journal of hospital infection, 106(3), 419-428. https://doi.org/10.1016/j.jhin.2020.09.006.
6. Itani, R., Khojah, H.M.J., Kibrit, R., Raychouni, H., Shuhaiber, P., Dib, C., Hassan, M., Mukattash, T.L., & El-Lakany, A. (2024). Risk factors associated with multidrug-resistant Klebsiella pneumoniae infections: a multicenter observational study in Lebanese hospitals. BMC public health, 24(1), 2958. https://doi.org/10.1186/s12889-024-20474-0.
7. Magiorakos, A.P., Srinivasan, A., Carey, R.B., Carmeli, Y., Falagas, M.E., Giske, C.G., Harbarth, S., Hindler, J.F., Kahlmeter, G., Olsson-Liljequist, B., Paterson, D.L., Rice, L.B., Stelling, J., Struelens, M.J., Vatopoulos, A., Weber, J.T., & Monnet, D.L. (2012). Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 18(3), 268-281. https://doi.org/10.1111/j.1469-0691.2011.03570.x.
8. Chen, T. A., Chuang, Y. T., & Lin, C. H. (2024). A Decade-Long Review of the Virulence, Resistance, and Epidemiological Risks of Klebsiella pneumoniae in ICUs. Microorganisms, 12(12), 2548. https://doi.org/10.3390/microorganisms12122548;
9. Büyüktuna, S.A., Hasbek, M., Çelik, C., Ünlüsavuran, M., Avcı, O., Baltacı, S., Fırtına Topcu, K., & Elaldı, N. (2020). Yoğun Bakım Ünitesinde Gelişen Klebsiella pneumoniae Enfeksiyonları: Karbapenem Direnci ve Hasta Mortalitesi ile İlgili Risk Faktörleri [Klebsiella pneumoniae Infections in the Intensive Care Unit: Risk Factors Related to Carbapenem Resistance and Patient Mortality]. Mikrobiyoloji bulteni, 54(3), 378-391. https://doi.org/10.5578/mb.69679.
10. Aiesh, B.M., Mousa, N., Jomaa, R., Zouneh, Y., Abuhalima, D., Saifi, M., Namrouti, A., Abutaha, A., Sweileh, M.W., Al-Jabi, S.W., Sabateen, A., & Zyoud, S.H. (2025). Epidemiology, resistance profiles, and risk factors of multidrug-resistant Klebsiella pneumoniae: experience from a low- and middle-income country. BMC infectious diseases, 25(1), 1421. https://doi.org/10.1186/s12879-025-11926-y.
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