Dataset Information

Mortality of Pandrug-Resistant Klebsiella pneumoniae Bloodstream Infections in Critically Ill Patients: A Retrospective Cohort of 115 Episodes.

ABSTRACT:

Background

The increased frequency of bacteraemias caused by pandrug-resistant Klebsiella pneumoniae (PDR-Kp) has significant implications. The aim of the present study was to identify predictors associated with mortality of PDR-Kp bacteraemias.

Methods

Patients with monomicrobial bacteraemia due to PDR-Kp were included. K. pneumoniae was considered PDR if it showed resistance to all available groups of antibiotics. Primary outcome was 30-day mortality. Minimum inhibitory concentrations (MICs) of meropenem, tigecycline, fosfomycin, and ceftazidime/avibactam were determined by Etest, whereas for colistin, the broth microdilution method was applied. bla_KPC, bla_VIM, bla_NDM, and bla_OXA genes were detected by PCR.

Results

Among 115 PDR-Kp bacteraemias, the majority of infections were primary bacteraemias (53; 46.1%), followed by catheter-related (35; 30.4%). All isolates were resistant to tested antimicrobials. bla_KPC was the most prevalent carbapenemase gene (98 isolates; 85.2%). Thirty-day mortality was 39.1%; among 51 patients with septic shock, 30-day mortality was 54.9%. Multivariate analysis identified the development of septic shock, Charlson comorbidity index, and bacteraemia other than primary or catheter-related as independent predictors of mortality, while a combination of at least three antimicrobials was identified as an independent predictor of survival.

Conclusions

Mortality of PDR-Kp bloodstream infections was high. Administration of at least three antimicrobials might be beneficial for infections in critically ill patients caused by such pathogens.

SUBMITTER: Papadimitriou-Olivgeris M

PROVIDER: S-EPMC7830393 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Mortality of Pandrug-Resistant <i>Klebsiella pneumoniae</i> Bloodstream Infections in Critically Ill Patients: A Retrospective Cohort of 115 Episodes.

Papadimitriou-Olivgeris Matthaios M Bartzavali Christina C Georgakopoulou Alexandra A Kolonitsiou Fevronia F Papamichail Chrisavgi C Spiliopoulou Iris I Christofidou Myrto M Fligou Fotini F Marangos Markos M

Antibiotics (Basel, Switzerland) 20210115 1

<h4>Background</h4>The increased frequency of bacteraemias caused by pandrug-resistant <i>Klebsiella</i> <i>pneumoniae</i> (PDR-Kp) has significant implications. The aim of the present study was to identify predictors associated with mortality of PDR-Kp bacteraemias.<h4>Methods</h4>Patients with monomicrobial bacteraemia due to PDR-Kp were included. <i>K. pneumoniae</i> was considered PDR if it showed resistance to all available groups of antibiotics. Primary outcome was 30-day mortality. Minimu ...[more]

PMID: 33467394

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