Risk Factors and Outcomes Associated with Acquisition of Colistin-Resistant KPC-Producing Klebsiella pneumoniae: a Matched Case-Control Study

被引：96

作者：

Zarkotou, Olympia ^{[1
]}

Pournaras, Spyros

Voulgari, Evangelia

Chrysos, Georgios ^{[2
]}

Prekates, Athanassios ^{[3
]}

Voutsinas, Dionysios

Themeli-Digalaki, Katerina ^{[1
]}

Tsakris, Athanassios

机构：

[1] Univ Thessaly, Dept Microbiol, Piraeus, Greece

[2] Univ Thessaly, Infect Dis Unit, Piraeus, Greece

[3] Univ Thessaly, ICU, Piraeus, Greece

来源：

JOURNAL OF CLINICAL MICROBIOLOGY | 2010年 / 48卷 / 06期

关键词：

POLYMYXIN-B; INFECTIONS; SPREAD; THREAT; GREECE;

D O I：

10.1128/JCM.02301-09

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

A matched 1: 3 case-control study investigated factors predicting colistin-resistant versus colistin-susceptible KPC-producing Klebsiella pneumoniae acquisition and its impact on patient outcomes. Case patients were more often admitted from other institutions (P = 0.019) and had longer therapy with beta-lactam/beta-lactamase inhibitors (P = 0.002) and higher overall mortality (P = 0.05). All 52 study isolates were clonally related, suggesting horizontal dissemination. None of these parameters independently predicted colistin resistance, which probably occurred in a susceptible KPC-KP strain that was subsequently disseminated horizontally.

引用

收藏

页码：2271 / 2274

页数：4

相关论文

共 18 条

[1] 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

[2] 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

[3] Antimicrobial activities of tigecycline and other broad-spectrum antimicrobials tested against serine carbapenemase- and metallo-β-lactamase-producing enterobactefiaceae:: Report from the SENTRY antimicrobial surveillance program [J].

Castanheira, Mariana ;

Sader, Helio S. ;

Deshpande, Lalitagauri M. ;

Fritsche, Thomas R. ;

Jones, Ronald N. .

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2008, 52 (02) :570-573

[4]

*CLIN LAB STAND I, 2008, M100S18 CLIN LAB S S

[5] Infection with Panresistant Klebsiella pneumoniae: A Report of 2 Cases and a Brief Review of the Literature [J].

Elemam, Azza ;

Rahimian, Joseph ;

Mandell, William .

CLINICAL INFECTIOUS DISEASES, 2009, 49 (02) :271-274

[6] Emergence of blaKPC-containing Klebsiella pneumoniae in a long-term acute care hospital: a new challenge to our healthcare system [J].

Endimiani, Andrea ;

DePasquale, John M. ;

Forero, Sandra ;

Perez, Federico ;

Hujer, Andrea M. ;

Roberts-Pollack, Daneshia ;

Fiorella, Paul D. ;

Pickens, Nancy ;

Kitchel, Brandon ;

Casiano-Colon, Aida E. ;

Tenover, Fred C. ;

Bonomo, Robert A. .

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2009, 64 (05) :1102-1110

[7]

*EUR COMM ANT SUSC, 2009, BREAK POINT TABL INT

[8] Phenotypic detection of carbapenem-susceptible metallo-β-lactamase-producing gram-negative bacilli in the clinical laboratory [J].

Franklin, Clare ;

Liolios, Lisa ;

Peleg, Anton Y. .

JOURNAL OF CLINICAL MICROBIOLOGY, 2006, 44 (09) :3139-3144

[9] CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].

GARNER, JS ;

JARVIS, WR ;

EMORI, TG ;

HORAN, TC ;

HUGHES, JM .

AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140

[10] Risk Factors and Clinical Impact of Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae [J].

Gasink, Leanne B. ;

Edelstein, Paul H. ;

Lautenbach, Ebbing ;

Synnestvedt, Marie ;

Fishman, Neil O. .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2009, 30 (12) :1180-1185