scholarly journals Risk factors for carbapenem-resistant Klebsiella pneumoniae bloodstream infection among rectal carriers: a prospective observational multicentre study

2014 ◽  
Vol 20 (12) ◽  
pp. 1357-1362 ◽  
Author(s):  
M. Giannella ◽  
E.M. Trecarichi ◽  
F.G. De Rosa ◽  
V. Del Bono ◽  
M. Bassetti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Multicentre Study ◽  
Bloodstream Infection ◽  
Carbapenem Resistant

scholarly journals Risk Factors of 30-Day All-Cause Mortality in Patients with Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infection

2021 ◽  
Vol 11 (7) ◽  
pp. 616
Author(s):  
Keh-Sen Liu ◽  
Yao-Shen Tong ◽  
Ming-Tsung Lee ◽  
Hung-Yu Lin ◽  
Min-Chi Lu
Keyword(s):  
Risk Factors ◽  
Platelet Count ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Carbapenem Resistant ◽  
All Cause Mortality ◽  
Insight Into ◽  
Antimicrobial Regimen

An optimal antimicrobial regimen for the treatment of patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection (BSI) is currently unavailable. This study aimed to identify the appropriate antibiotics and the risk factors of all-cause mortality for CRKP BSI patients. This retrospective cohort study included the hospitalized patients with CRKP BSI. Primary outcome was 30-day all-cause mortality. Cox regression analysis was used to evaluate the risk factors of 30-day mortality. A total of 89 patients were included with a 30-day mortality of 52.1%. A total of 52 (58.4%) patients were treated with appropriate antimicrobial regimens and 58 (65.2%) isolates carried blaKPC-2 genes. Microbiologic eradication within 7 days (adjusted hazard ratio [HR] = 0.09, p < 0.001), platelet count (per 1 × 104/mm3, adjusted HR = 0.95, p = 0.002), and Pitt bacteremia scores (adjusted HR = 1.40, p < 0.001) were independently associated with 30-day all-cause mortality. No effective antimicrobial regimens were identified. In conclusion, risk factors of 30-day mortality in patients with CRKP BSI included microbiologic eradication > 7 days, lower platelet count, and a higher Pitt bacteremia score. These findings render a new insight into the clinical landscape of CRKP BSI.

Risk factors for recurrent carbapenem resistant Klebsiella pneumoniae bloodstream infection: a prospective cohort study

2017 ◽  
Vol 36 (10) ◽  
pp. 1965-1970 ◽  
Author(s):  
Maddalena Giannella ◽  
Elena Graziano ◽  
Lorenzo Marconi ◽  
Nicolo Girometti ◽  
Michele Bartoletti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Carbapenem Resistant

scholarly journals Clinical and Bacterial Characteristics of Klebsiella pneumoniae Affecting 30-Day Mortality in Patients With Bloodstream Infection

2021 ◽  
Vol 11 ◽  
Author(s):  
Xingbing Wu ◽  
Qingyi Shi ◽  
Shimo Shen ◽  
Chen Huang ◽  
Hongcheng Wu
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
High Mortality ◽  
Virulence Genes ◽  
Genomic Analysis ◽  
Apache Ii Score ◽  
Comparative Genomic ◽  
Carbapenem Resistant

BackgroundThere is a paucity of studies using clinical characteristics and whole-genome sequencing together to fully identify the risk factors of patients with Klebsiella pneumoniae (KP) bloodstream infection (BSI).MethodsWe retrospectively analyzed the clinical and microbiological characteristics of patients with KP BSI. Isolates were processed using Illumina NGS, and relevant bioinformatics analysis was conducted (multi-locus sequence typing, serotype, phylogenetic reconstruction, detection of antibiotic resistance, and virulence genes). A logistic regression model was used to evaluate the risk factors of hosts and causative KP isolates associated with 30-day mortality in patients infected with KP BSI.ResultsOf the 79 eligible patients, the 30-day mortality rate of patients with KP BSI was 30.4%. Multivariate analysis showed that host-associated factors (increased APACHE II score and septic shock) were strongly associated with increased 30-day mortality. For the pathogenic factors, carriage of iutA (OR, 1.46; 95% CI, 1.11–1.81, p = 0.002) or Kvar_1549 (OR, 1.31; 95% CI, 1.02–1.69, p = 0.043) was an independent risk factor, especially when accompanied by a multidrug-resistant phenotype. In addition, ST11-K64 hypervirulent carbapenem-resistant KP co-harbored acquired blaKPC-2 together with iutA (76.5%, 13/17) and Kvar_1549 (100%, 17/17) genes. Comparative genomic analysis showed that they were clustered together based on a phylogenetic tree, and more virulence genes were observed in the group of ST11-K64 strains compared with ST11-non-K64. The patients infected with ST11-K64 strains were associated with relatively high mortality (47.2%, 7/17).ConclusionThe carriage of iutA and Kvar_1549 was seen to be an independent mortality risk factor in patients with KP BSI. The identification of hypervirulent and carbapenem-resistant KP strains associated with high mortality should prompt surveillance.

scholarly journals Clinical Characteristics and Risk Factors for Bloodstream Infection due to Carbapenem-Resistant Klebsiella Pneumoniae in Patients with Hematologic Malignancies

2020 ◽  
Author(s):  
Piaopiao Zhang ◽  
Jie Wang ◽  
Hangbin Hu ◽  
Sheng Zhang ◽  
Juying Wei ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infection ◽  
Hematologic Malignancy ◽  
Invasive Mechanical Ventilation ◽  
Hematologic Malignancies ◽  
Severe Neutropenia ◽  
Total Risk ◽  
Retrospective Case ◽  
Carbapenem Resistant

Abstract Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) associated infections are a major threat to patient safety. Methods: A single-center, retrospective case-control study representing 734 patients with hematologic malignancies between January 1, 2017 and December 31, 2018 was conducted. Demographic and clinical data were collected from the hospital electronic medical records system. Results: Among the 734 patients with hematologic malignancies, 3% (22/734) of the patients developed CRKP BSI during their hospitalization. Overall 28-day all-cause mortality reached 77.3% (17/22). Patients with Pitt Bacteremia Score (PBS) >4, pneumonia and septic shock were more frequent in the non-survivors versus the survivors . Compared with the non-survivors in antimicrobial treatment, combination therapy of tigecycline and polymyxin B was more common in the survivors. The independent risk factors associated with CRKP BSI were CRKP rectal colonization (OR,11.067; CI=4.43-27.644; P<0.001; 3 points), severe neutropenia (OR,4.095; CI=0.876-19.141; P=0.073; 1 point) and invasive mechanical ventilation (IMV) within the previous 30 days to onset of BSI (OR,18.444; CI=1.787-190.343; P=0.014; 4 points). The total risk score of ≥5 indicated that the probability of CRKP BSI occurrence was above 48%. Conclusions: CRKP BSI in patients with hematologic malignancies is associated with high mortality. The risk factor–based prediction model might help clinicians to start prompt effective anti-infective therapy in patients with suspicion of CRKP BSI and improve outcomes. Keywords: Carbapenem-resistant Klebsiella pneumoniae ; bloodstream infection; hematologic malignancy; risk factors; prediction

Disease Severity Is an Independent Risk Factor of Mortality and Outcomes in Critically Ill Patients With Carbapenem-resistant Klebsiella Pneumoniae Bloodstream Infections: a 5-year Retrospective Analysis

2021 ◽  
Author(s):  
Yuzhen Qiu ◽  
Wen Xu ◽  
Yunqi Dai ◽  
Ruoming Tan ◽  
Jialin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septic Shock ◽  
Klebsiella Pneumoniae ◽  
Critically Ill Patients ◽  
Bloodstream Infections ◽  
Polymyxin B ◽  
Mortality Rates ◽  
Carbapenem Resistant ◽  
All Cause Mortality ◽  
Independent Risk Factors

Abstract Background: Carbapenem-resistant Klebsiella pneumoniae bloodstream infections (CRKP-BSIs) are associated with high morbidity and mortality rates, especially in critically ill patients. Comprehensive mortality risk analyses and therapeutic assessment in real-world practice are beneficial to guide individual treatment.Methods: We retrospectively analyzed 87 patients with CRKP-BSIs (between July 2016 and June 2020) to identify the independent risk factors for 28-day all-cause mortality. The therapeutic efficacies of tigecycline-and polymyxin B-based therapies were analyzed.Results: The 28-day all-cause mortality and in-hospital mortality rates were 52.87% and 67.82%, respectively, arising predominantly from intra-abdominal (56.32%) and respiratory tract infections (21.84%). A multivariate analysis showed that 28-day all-cause mortality was independently associated with the patient’s APACHE II score (p = 0.002) and presence of septic shock at BSI onset (p = 0.006). All-cause mortality was not significantly different between patients receiving tigecycline- or polymyxin B-based therapy (55.81% vs. 53.85%, p = 0.873), and between subgroups mortality rates were also similar. Conclusions: Critical illness indicators (APACHE II scores and presence of septic shock at BSI onset) were independent risk factors for 28-day all-cause mortality. There was no significant difference between tigecycline- and polymyxin B-based therapy outcomes. Prompt and appropriate infection control should be implemented to prevent CRKP infections.

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