Carbapenem-resistant Klebsiella pneumoniae bacteremia: factors correlated with clinical and microbiologic outcomes

被引：89

作者：

Nguyen, May ^{[1
]}

Eschenauer, Gregory A. ^{[2
]}

Bryan, Monique ^{[1
]}

O'Neil, Kelly ^{[1
]}

Furuya, E. Yoko ^{[3
]}

Della-Latta, Phyllis ^{[4
]}

Kubin, Christine J. ^{[1
]}

机构：

[1] Columbia Univ, Med Ctr, NewYork Presbyterian Hosp, Dept Pharm, New York, NY 10032 USA

[2] Univ Pittsburgh, Med Ctr, Dept Pharm, Pittsburgh, PA 15213 USA

[3] Columbia Univ, Med Ctr, NewYork Presbyterian Hosp, Dept Med, New York, NY 10032 USA

[4] Columbia Univ, Med Ctr, NewYork Presbyterian Hosp, Dept Pathol, New York, NY 10032 USA

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2010年 / 67卷 / 02期

关键词：

Polymyxin; Tigecycline; Carbapenem; Klebsiella; NEW-YORK-CITY; EPIDEMIOLOGY; INFECTION; EMERGENCE; SEVERITY; BROOKLYN; THREAT; IMPACT;

D O I：

10.1016/j.diagmicrobio.2010.02.001

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

We undertook a retrospective cohort study describing general outcomes and specific factors associated with positive outcomes in bacteremia due to carbapenem-resistant Klebsiella pneumoniae (CRKP). Forty-eight patients were included, of which 42% died at 30 days. Forty-two percent of patients were in septic shock at the time of the first positive blood culture, and 42% were recipients of solid organ transplants. Lack of microbiologic eradication at 7 days was independently associated with 30-day mortality. Adjunctive procedures performed for source control and microbiologic eradication at 7 days were associated with a favorable clinical response at 7 days. Time to initiation and receipt at any time of antimicrobials with in vitro activity against CRKP were not associated with improved survival. Breakthrough bacteremia occurred in 8 cases, all in patients receiving tigecycline. Our data suggest that severity of illness, rapid microbiologic eradication, and source control are crucial factors in the outcomes of patients with CRKP bacteremia. (C) 2010 Elsevier Inc. All rights reserved.

引用

页码：180 / 184

页数：5

共 12 条

[1] 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].