Outcome of carbapenem resistant Klebsiella pneumoniae bloodstream infections

被引:290
作者
Ben-David, D. [1 ]
Kordevani, R. [1 ]
Keller, N. [1 ]
Tal, I. [1 ]
Marzel, A. [1 ]
Gal-Mor, O. [1 ]
Maor, Y. [1 ]
Rahav, G. [1 ]
机构
[1] Chaim Sheba Med Ctr, Infect Dis Unit, IL-52621 Tel Hashomer, Israel
关键词
Bloodstream infection; carbapenem resistance; Klebsiella pneumoniae; outcome; LACTAMASE-PRODUCING ENTEROBACTERIACEAE; INTENSIVE-CARE-UNIT; NEW-YORK-CITY; MOLECULAR EPIDEMIOLOGY; ESCHERICHIA-COLI; RISK-FACTORS; CLINICAL-OUTCOMES; BETA-LACTAMASES; BACTEREMIA; MORTALITY;
D O I
10.1111/j.1469-0691.2011.03478.x
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
The aim of this study was to evaluate the impact of carbapenem-resistant K. pneumoniae bloodstream infections on mortality. During the study period 42, 68 and 120 patients were identified with carbapenem-resistant, extended-spectrum beta-lactamase producers (ESBL) and susceptible K. pneumoniae bloodstream infections, respectively. Patients with carbapenem-resistant K. pneumoniae had higher rates of prior antimicrobial exposure, other nosocomial infections, and use of invasive devices. Infection-related mortality was 48% for carbapenem-resistant, 22% for ESBL producers and 17% for susceptible K. pneumoniae. Independent risk factors for infection-related mortality were Pitt bacteraemia score, Charlson score and carbapenem resistance.
引用
收藏
页码:54 / 60
页数:7
相关论文
共 34 条
[1]   Evaluation of methods to identify the Klebsiella pneumoniae carbapenemase in Enterobactetiaceae [J].
Anderson, K. F. ;
Lonsway, D. R. ;
Rasheed, J. K. ;
Biddle, J. ;
Jensen, B. ;
McDougal, L. K. ;
Carey, R. B. ;
Thompson, A. ;
Stocker, S. ;
Limbago, B. ;
Patel, J. B. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2007, 45 (08) :2723-2725
[2]  
[Anonymous], 2006, PERFORMANCE STANDA S
[3]   Outcomes evaluation of patients with ESBL- and non-ESBL-producing Escherichia coli and Klebsiella species as defined by CLSI reference methods:: report from the SENTRY Antimicrobial Surveillance Program [J].
Bhavnani, SM ;
Ambrose, PG ;
Craig, WA ;
Dudley, MN ;
Jones, RN .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2006, 54 (03) :231-236
[4]   Attributable Mortality Rate for Carbapenem-Resistant Klebsiella pneumoniae Bacteremia [J].
Borer, Abraham ;
Saidel-Odes, Lisa ;
Riesenberg, Klaris ;
Eskira, Seada ;
Peled, Nejama ;
Nativ, Ronit ;
Schlaeffer, Francisc ;
Sherf, Michael .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2009, 30 (10) :972-976
[5]   Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 β-lactamases in New York City [J].
Bradford, PA ;
Bratu, S ;
Urban, C ;
Visalli, M ;
Mariano, N ;
Landman, D ;
Rahal, JJ ;
Brooks, S ;
Cebular, S ;
Quale, J .
CLINICAL INFECTIOUS DISEASES, 2004, 39 (01) :55-60
[6]   Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY:: molecular epidemiology and in vitro activity of polymyxin B and other agents [J].
Bratu, S ;
Tolaney, P ;
Karumudi, U ;
Quale, J ;
Mooty, M ;
Nichani, S ;
Landman, D .
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2005, 56 (01) :128-132
[7]   Rapid spread of carbapenem-resistant Klebsiella pneumoniae in New York City -: A new threat to our antibiotic armamentarium [J].
Bratu, S ;
Landman, D ;
Haag, R ;
Recco, R ;
Eramo, A ;
Alam, M ;
Quale, J .
ARCHIVES OF INTERNAL MEDICINE, 2005, 165 (12) :1430-1435
[8]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[9]   Evaluation of risk factors for the acquisition of bloodstream infections with extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella species in the intensive care unit;: antibiotic management and clinical outcome [J].
Cordery, R. J. ;
Roberts, C. H. ;
Cooper, S. J. ;
Bellinghan, G. ;
Shetty, N. .
JOURNAL OF HOSPITAL INFECTION, 2008, 68 (02) :108-115
[10]   National Healthcare Safety Network (NHSN) Report, data summary for 2006 through 2007, issued November 2008 [J].
Edwards, Jonathan R. ;
Peterson, Kelly D. ;
Andrus, Mary L. ;
Dudeck, Margaret A. ;
Pollock, Daniel A. ;
Horan, Teresa C. .
AMERICAN JOURNAL OF INFECTION CONTROL, 2008, 36 (09) :609-626