Renggli, Luzia SonjaLuzia SonjaRenggliGasser, MichaelMichaelGasserPlüss, CatherineCatherinePlüss0000-0002-2475-8057Harbarth, S.S.HarbarthKronenberg, Andreas OskarAndreas OskarKronenberg0000-0002-0006-78332024-10-062024-10-062022-02https://boris-portal.unibe.ch/handle/20.500.12422/57732Background: 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 [1]. Aim: 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. Methods: 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. Findings: An increasing incidence of invasive ESCR-KP infections from 0.01 to 0.04 patients/1,000 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). Conclusion: 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.en500 - Science::570 - Life sciences; biology600 - Technology::610 - Medicine & healtharticle10.48350/1615043479817210.1016/j.jhin.2021.11.006