Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae

Importance of combination therapy

Mario Tumbarello, Pierluigi Viale, Claudio Viscoli, Enrico Maria Trecarichi, Fabio Tumietto, Anna Marchese, Teresa Spanu, Simone Ambretti, Francesca Ginocchio, Francesco Cristini, Angela Raffaella Losito, Sara Tedeschi, Roberto Cauda, Matteo Bassetti

Research output: Contribution to journalArticle

555 Citations (Scopus)

Abstract

Background.The spread of Klebsiella pneumoniae (Kp) strains that produce K. pneumoniae carbapenemases (KPCs) has become a significant problem, and treatment of infections caused by these pathogens is a major challenge for clinicians.Methods.In this multicenter retrospective cohort study, conducted in 3 large Italian teaching hospitals, we examined 125 patients with bloodstream infections (BSIs) caused by KPC-producing Kp isolates (KPC-Kp) diagnosed between 1 January 2010 and 30 June 2011. The outcome measured was death within 30 days of the first positive blood culture. Survivor and nonsurvivor subgroups were compared to identify predictors of mortality.Results.The overall 30-day mortality rate was 41.6. A significantly higher rate was observed among patients treated with monotherapy (54.3 vs 34.1 in those who received combined drug therapy; P =. 02). In logistic regression analysis, 30-day mortality was independently associated with septic shock at BSI onset (odds ratio [OR]: 7.17; 95 confidence interval [CI]: 1.65-31.03; P =. 008); inadequate initial antimicrobial therapy (OR: 4.17; 95 CI: 1.61-10.76; P =. 003); and high APACHE III scores (OR: 1.04; 95 CI: 1.02-1.07; P

Original languageEnglish
Pages (from-to)943-950
Number of pages8
JournalClinical Infectious Diseases
Volume55
Issue number7
DOIs
Publication statusPublished - Oct 1 2012

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Klebsiella pneumoniae
Mortality
Odds Ratio
Confidence Intervals
Infection
APACHE
Therapeutics
Septic Shock
Teaching Hospitals
Survivors
Cohort Studies
Retrospective Studies
Logistic Models
Regression Analysis
Drug Therapy
carbapenemase

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae : Importance of combination therapy. / Tumbarello, Mario; Viale, Pierluigi; Viscoli, Claudio; Trecarichi, Enrico Maria; Tumietto, Fabio; Marchese, Anna; Spanu, Teresa; Ambretti, Simone; Ginocchio, Francesca; Cristini, Francesco; Losito, Angela Raffaella; Tedeschi, Sara; Cauda, Roberto; Bassetti, Matteo.

In: Clinical Infectious Diseases, Vol. 55, No. 7, 01.10.2012, p. 943-950.

Research output: Contribution to journalArticle

Tumbarello, M, Viale, P, Viscoli, C, Trecarichi, EM, Tumietto, F, Marchese, A, Spanu, T, Ambretti, S, Ginocchio, F, Cristini, F, Losito, AR, Tedeschi, S, Cauda, R & Bassetti, M 2012, 'Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: Importance of combination therapy', Clinical Infectious Diseases, vol. 55, no. 7, pp. 943-950. https://doi.org/10.1093/cid/cis588
Tumbarello, Mario ; Viale, Pierluigi ; Viscoli, Claudio ; Trecarichi, Enrico Maria ; Tumietto, Fabio ; Marchese, Anna ; Spanu, Teresa ; Ambretti, Simone ; Ginocchio, Francesca ; Cristini, Francesco ; Losito, Angela Raffaella ; Tedeschi, Sara ; Cauda, Roberto ; Bassetti, Matteo. / Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae : Importance of combination therapy. In: Clinical Infectious Diseases. 2012 ; Vol. 55, No. 7. pp. 943-950.
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AU - Viscoli, Claudio

AU - Trecarichi, Enrico Maria

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AU - Spanu, Teresa

AU - Ambretti, Simone

AU - Ginocchio, Francesca

AU - Cristini, Francesco

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AU - Tedeschi, Sara

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