Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: A nationwide retrospective survey from Italy

C. Girmenia, G. M. Rossolini, A. Piciocchi, A. Bertaina, G. Pisapia, D. Pastore, S. Sica, A. Severino, L. Cudillo, F. Ciceri, R. Scimè, L. Lombardini, C. Viscoli, A. Rambaldi

Research output: Contribution to journalArticle

Abstract

Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

Original languageEnglish
Pages (from-to)282-288
Number of pages7
JournalBone Marrow Transplantation
Volume50
Issue number2
DOIs
Publication statusPublished - Feb 7 2015

ASJC Scopus subject areas

  • Hematology
  • Transplantation
  • Medicine(all)

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    Girmenia, C., Rossolini, G. M., Piciocchi, A., Bertaina, A., Pisapia, G., Pastore, D., Sica, S., Severino, A., Cudillo, L., Ciceri, F., Scimè, R., Lombardini, L., Viscoli, C., & Rambaldi, A. (2015). Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: A nationwide retrospective survey from Italy. Bone Marrow Transplantation, 50(2), 282-288. https://doi.org/10.1038/bmt.2014.231