Attributable Mortality Rate for Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Bacteremia

Borer, Abraham; Saidel-Odes, Lisa; Riesenberg, Klaris; Eskira, Seada; Peled, Nechama; Nativ, Ronit; Schlaeffer, Francisc; Sherf, Michael

doi:10.1086/605922

Cited by 370 publications

(293 citation statements)

References 20 publications

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“…In a recent report describing the morbidity and mortality of patients with CRKP, the mortality risk ratio was 3.3 in patients with mostly non-malignant diseases. 27 In our study, 8/15 colonized patients developed bacteremia, and in all but one of them the bacteremia was persistent. In all, 7/8 of the bacteremic patients were neutropenic.…”

Section: Discussionsupporting

confidence: 48%

SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state

Zuckerman

Benyamini

Sprecher

et al. 2010

Bone Marrow Transplant

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Following an outbreak of carbapenem resistant Klebsiella pneumoniae (CRKP) bacteremia among inpatients in the Hemato-oncology and BMT unit, we studied the course of this infection in patients undergoing intensive chemotherapy and SCT. In addition, we conducted a pilot study aimed to eradicate CRKP colonization in the gastrointestinal tract, using oral gentamicin. Adult patients admitted to the BMT unit, identified as CRKP carriers on surveillance rectal cultures, were included in the study. Oral gentamicin at a dose of 80 mg q.i.d. was administered to all identified carriers until eradication. Among 15 colonized patients included in the study, the eradication rate achieved was 66% (10/15); discontinuation of persistent bacteremia occurred in 62.5% (5/8) and nosocomial spread of CRKP carrier state ceased. Administration of intensive chemotherapy and SCT is feasible, although associated with increased risk. Hematological patients in need of intensive chemotherapy/SCT should not be denied the required treatment on the basis of being CRKP carriers. Oral gentamicin treatment for eradication of CRKP from the gastrointestinal reservoir could serve as additional tool in the combat against the nosocomial spread and severe infections caused by this difficult-to-treat organism.

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Section: Discussionsupporting

confidence: 48%

SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state

Zuckerman

Benyamini

Sprecher

et al. 2010

Bone Marrow Transplant

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“…CPE transmission may occur in both healthcare and community settings 1,6,7 . Hospitalized patients may be particularly susceptible to infections; CPE is associated with increased risks of morbidity and mortality, prolonged hospital stays, and increased healthcare costs 8,9 . A number of risk factors for CPE acquisition have been identified, including previous hospitalization (particularly abroad e.g.…”

Section: Introductionmentioning

confidence: 99%

Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review

French

Coope

Conway

et al. 2017

Journal of Hospital Infection

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“…They can lead to severe diseases such as pneumonia, meningitis, liver abscess, urinary tract inflammation and septicemia and can cause severe morbidity and mortality (Borer et al 2009). Among Klebsiella strains isolated from hospitalised patients, Klebsiella pneumoniae is the mostfrequently encountered species, followed by Klebsiella oxytoca (Baraniak et al 2016;Pena et al 2001).…”

Section: Introductionmentioning

confidence: 99%

Comparative analyses of phenotypic methods and 16S rRNA, khe, rpoB genes sequencing for identification of clinical isolates of Klebsiella pneumoniae

Guo

Shifei

et al. 2016

Antonie van Leeuwenhoek

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The present work aimed to evaluate 16S rRNA, khe and rpoB gene sequencing for the identification of Klebsiella pneumoniae in comparison with phenotypic methods. Fifteen clinical isolates were examined, which were initially identified as K. pneumoniae subsp. pneumoniae using the automated VITEK 32 system in two hospitals in Enshi City, China. Their identity was further supported by conventional phenotypic methods on the basis of morphological and biochemical characteristics. Using Bayesian phylogenetic analyses and haplotypes network reconstruction, 13 isolates were identified as K.pneumoniae, whereas the other two isolates (K19, K24) were classified as Shigella sp. and Enterobacter sp., respectively. Of the three genes, 16S rRNA and khe gene could discriminate the clinical isolates at the genus level, whereas rpoB could discriminate Klebsiella at the species and even subspecies level. Overall, the gene tree based on rpoB is more compatible with the currently accepted classification of Klebsiella than those based on 16S rRNA and khe genes, showing that rpoB can be a powerful tool for identification of K. pneumoniae isolates. Above all, our study challenges the utility of khe as a species-specific marker for identification of K. pneumoniae.Electronic supplementary material The online version of this article

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Attributable Mortality Rate for Carbapenem-Resistant Klebsiella pneumoniae Bacteremia

Abstract: Patients with carbapenem-resistant K. pneumoniae require more intensive and invasive care. We have shown that the crude and attributable mortality rates associated with carbapenem-resistant K. pneumoniae bacteremia were striking.

Cited by 370 publications

References 20 publications

SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state

SCT in patients with carbapenem resistant Klebsiella pneumoniae: a single center experience with oral gentamicin for the eradication of carrier state

Control of carbapenemase-producing Enterobacteriaceae outbreaks in acute settings: an evidence review

Comparative analyses of phenotypic methods and 16S rRNA, khe, rpoB genes sequencing for identification of clinical isolates of Klebsiella pneumoniae

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