Clinical outcomes associated with carbapenem resistant <i>Klebsiella pneumoniae</i> (CRKP) in abdominal solid organ transplant (SOT) recipients

Bias, Tiffany; Malat, Gregory; Lee, Dong H; Sharma, Akshay; Doyle, Alden

doi:10.1080/23744235.2017.1354259

Cited by 10 publications

(13 citation statements)

References 8 publications

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“…Of the 43 patients with CRKP infections, 16 (37.2%) died. Previous studies showed that the overall mortality of transplant recipients with CRKP infections was as high as 40%~75% (Mazza et al, 2017;Bias et al, 2018;Wang et al, 2020). In our study, the Kaplan-Meier curves showed that the one-year survival rate after transplantation in the CRKP-infected group was significantly lower than that in the control group.…”

Section: Discussionsupporting

confidence: 46%

“…Those two studies showed that when liver transplant recipients were infected with CRKP, the 1-year survival rate decreased significantly from 86% to 29% and from 93% to 55% (Kalpoe et al, 2012;Pereira et al, 2015). In this study, a total of 43 recipients had CRKP infections, yielding an infection rate of (Clancy et al, 2013;Varotti et al, 2017;Bias et al, 2018).…”

Section: Discussionmentioning

confidence: 55%

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Analysis of Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection and Its Effect on the Outcome of Early Infection After Kidney Transplantation

Zhang

Zhong

Ding

et al. 2021

Front. Cell. Infect. Microbiol.

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BackgroundInfections remain a major cause of morbidity and mortality in kidney transplant (KT) recipients. This study was performed to identify the overall prevalence of early infections, prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection after KT, one-year postoperative mortality in patients with early infections and risk factors for CRKP infections.MethodsWe conducted a retrospective study of all patients who received KT in our hospital between January 2017 and December 2019. We evaluated the demographic, clinical, infection characteristics and the one-year postoperative outcomes.ResultsAmong the 419 patients who received KT between January 2017 and December 2019, 150 patients had at least one infection within 90 days after KT. The total prevalence of early infections was 36.1% (150/415), the prevalence of early CRKP infections was 10.4% (43/415), and the one-year postoperative mortality was 15.3% (23/150) in patients with early infections. The risk factors independently related to one-year postoperative mortality were mechanical ventilation (MV) > 48 h (Odds ratio (OR)= 13.879, 95%Confidence interval (CI): 2.265~85.035; P=0.004) and CRKP infection (OR=6.751, 95% CI: 1.051~43.369; P =0.044). MV> 48 h was independently related to CRKP infection (OR=3.719, 95% CI: 1.024~13.504; P=0.046). Kaplan-Meier survival curves showed that the one-year survival rate of patients infected with CRKP in the early postoperative stage was significantly lower than that of uninfected patients.ConclusionsIn general, the prevalence of early infections after KT is high, and CRKP infection is closely correlated with poor prognosis. The effective prevention and treatment of CRKP infection is an important way to improve the one-year survival rate after KT.

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Section: Discussionsupporting

confidence: 46%

Section: Discussionmentioning

confidence: 55%

Analysis of Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection and Its Effect on the Outcome of Early Infection After Kidney Transplantation

Zhang

Zhong

Ding

et al. 2021

Front. Cell. Infect. Microbiol.

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“…ASOT recipients with CRKP infections may be treated with appropriate antibiotics only after lengthy delays, due to missed identification and drug-resistance testing of CRKP strains, costing up to 3 days. In line with previous studies, inappropriate empirical antibiotics use was a risk factor associated with crude mortality as K. pneumoniae infections were related to high prevalence of drug-resistance [ 35 – 38 ]. Therapies for patients with drug-resistant infections were reported to be limited due to severe deficiency of effective antibiotics [ 39 ].…”

Section: Discussionsupporting

confidence: 80%

Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections

Chen

Liu

et al. 2020

Med Sci Monit

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Background For abdominal solid organ transplant (ASOT) recipients, infection with Klebsiella pneumoniae , particularly carbapenem-resistant K. pneumoniae (CRKP), can be life-threatening. The aims of this study were to characterize the risk factors associated with acquisition of CRKP and 90-day crude mortality among patients. Material/Methods In our cohort study, we retrospectively reviewed 68 K. pneumoniae -infected transplant recipients, studied their demographics, clinical manifestations, microbiology, and outcomes, and determined the risk factors associated with the occurrence of CRKP and crude mortality due to K. pneumoniae infections. Results Sixty-eight ASOT recipients (5.4%) experienced 78 episodes of K. pneumoniae infection. Among these, 20 patients (29.4%) died. The independent risk factors associated with mortality were multiple infected organs or sites (odds ratio=22.034, 95% confidence intervals=4.348–111.653, P =0.001) and septic shock (odds ratio=27.090, 95% confidence intervals=1.841–398.512, P =0.016). Risk factors associated with acquisition of CRKP were multiple infected organs or sites (odds ratio=3.056, 95% confidence intervals=1.091–8.556, P =0.033). Conclusions K. pneumoniae infections, especially CRKP, frequently occurred among ASOT recipients, with a high mortality rate. Multiple infected organs or sites and septic shock were predictors of crude mortality caused by K. pneumoniae infections, while CRKP infections were associated with multiple infected organs or sites. Greater efforts are needed towards improved antibiotic administration, early diagnosis and precise treatment, recognition of septic shock, and reduced length of hospitalization.

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“…The detected specimens mainly include sputum (26.6%), ascites (26.1%), and blood (13.3%), which reflects the infection sites are mainly lung, abdominal cavity, and blood. GNB is the primary pathogen in which K. pneumoniae was the most (18.4% (Bias et al, 2018;Wang et al, 2020). Our survey showed that twelve (63.2%) cases were dead in 19 CRKP-infected recipients.…”

Section: Discussionmentioning

confidence: 70%

Epidemic, risk factors of carbapenem-resistant Klebsiella pneumoniae infection and its effect on the early prognosis of liver transplantation

Liu

Yang²,

Dang³

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundCarbapenem-resistant Klebsiella pneumoniae (CRKP) infection remains a major cause of morbidity and mortality in early-stage post-liver transplantation (LT).MethodsWe retrospectively analyzed the demographic and clinical infections characteristics of all LT recipients in our hospital between January 2019 and December 2021.ResultsAmong the 272 LT recipients who received LT between January 2019 and December 2021, sixty-two patients had at least one infection within 3-months post-LT, with a prevalence of 22.8% (62/272). The prevalence of CRKP infections was 7.0% (19/272), and the 3-months post-LT mortality was 19.4% (12/62). The risk factors independently related to 3-months mortality were age (Odds ratio (OR)= 1.126, 95% Confidence interval (CI): 1.009~1.257; P=0.034), mechanical ventilation (MV) (OR=1.206, 95% CI: 1.039~1.401; P =0.014), and CRKP infection (OR=18.240, 95% CI: 2.206~150.842; P =0.007). In CRKP infection, the length of ICU stay (OR=1.067, 95% CI: 1.015~1.122; P=0.011), pre-operation infection (POI) (OR=6.733, 95% CI: 1.160~39.088; P=0.034), and hepatocellular carcinoma (HCC) (OR=26.772, 95% CI: 1.747~410.187; P=0.018) were the independent risk factors. With COX multivariate regression analysis, the 3-months survival rate of CRKP infected patients was significantly lower than that without CRKP infection post-LT.ConclusionsCRKP infection is closely correlated with poor prognosis in 3-months post-LT.

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Clinical outcomes associated with carbapenem resistant Klebsiella pneumoniae (CRKP) in abdominal solid organ transplant (SOT) recipients

Cited by 10 publications

References 8 publications

Analysis of Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection and Its Effect on the Outcome of Early Infection After Kidney Transplantation

Analysis of Risk Factors for Carbapenem-Resistant Klebsiella pneumoniae Infection and Its Effect on the Outcome of Early Infection After Kidney Transplantation

Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections

Epidemic, risk factors of carbapenem-resistant Klebsiella pneumoniae infection and its effect on the early prognosis of liver transplantation

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