Impact of carbapenem resistance on the outcome of patients' hospital-acquired bacteraemia caused by Klebsiella pneumoniae

Hussein, Khetam; Raz-Pasteur, Ayelet; Finkelstein, Renato; Neuberger, Ami; Shachor-Meyouhas, Yael; Oren, Ilana; Kassis, Imad

doi:10.1016/j.jhin.2012.10.012

Cited by 134 publications

(126 citation statements)

References 23 publications

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“…[53][54][55] These areas also report that alarmingly high proportions of Gram-negative bacteremias are due to CRE in this population. Multicenter studies from New York City and Italy have reported that CRE represent 5-6% of all Gram-negative bacteremias in patients with hematologic malignancies, 56,57 and single centers from Israel and Italy have reported that CRE represent 16-18% of Gram-negative bacteremias.…”

Section: Cre In Patients With Hematologic Malignancies and Haematopoimentioning

confidence: 80%

Carbapenem-resistant Enterobacteriaceae in special populations: Solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies

2016

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Carbapenem-resistant Enterobacteriaceae (CRE) are a major global public health concern and pose a serious threat to immunocompromised hosts, particularly patients with hematologic malignancies and solid organ (SOT) and stem cell transplant recipients. In endemic areas, carbapenem-resistant Klebsiella pneumoniae infections occur in 1-18% of SOT recipients, and patients with hematologic malignancies represent 16-24% of all patients with CRE bacteremia. Mortality rates approaching 60% have been reported in these patient populations. Early diagnosis and rapid initiation of targeted therapy is critical in the management of immunocompromised hosts with CRE infections, as recommended empiric regimens are not active against CRE. Therapeutic options are limited by antibiotic-associated toxicities, interactions with immunosuppressive agents, and paucity of antibiotic options currently available. Prevention of CRE infection in these patients requires a multidisciplinary approach involving hospital epidemiology and antimicrobial stewardship. Large, multicenter studies are needed to develop risk-stratification tools to assist in guiding the management of these individuals.

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Section: Cre In Patients With Hematologic Malignancies and Haematopoimentioning

confidence: 80%

Carbapenem-resistant Enterobacteriaceae in special populations: Solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies

2016

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“…In countries such as the United States, Israel,Germany and Greece, carbapenemase-producing Enterobacteriaceae (CPE) had emerged and the dissemination of these multidrug-resistant pathogens had become a problem in clinical care of patients and in public health [4][5][6][7] . Invasive infections with these organisms have been associated with high rates of morbidity and mortality, due to their resistance to most available antimicrobial agents [8][9][10] . Patients who are hospitalized for prolonged periods and those with severe underlying disease are at high risk of acquiring these types of pathogens 11 .…”

Section: Introductionmentioning

confidence: 99%

Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital

Pang¹,

Jia²,

Song³

et al. 2016

Afr H. Sci.

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Background: The emergence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases is rare. We report an occurrence of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemases in a Chinese tertiary care hospital from November 2010 to December 2012. Methods: The clinical characteristics of 30 patients were described. The genetic relationship of isolates was determined by pulsed-field gel electrophoresis (PFGE). Carbapenemases were detected by modified Hodge test (MHT) and polymerase chain reactions (PCRs). Amplicons were sequenced and blasted to determine the genotype. Results: Most infected patients were from intensive care unit and had complex and serious underlying illnesses requiring mechanical ventilation. PFGE revealed that Klebsiella pneumoniae showed two major PFGE types. Two Klebsiella oxytoca had an indistinguishable PFGE pattern, while four Enterobacter cloacae were different strains. The sequencing studies showed Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in the 23 infected patients. The majority of patients had infections with the carbapenemase-producing Enterobacteriaceae (CPE) strain, most were successfully treated with a range of antibiotics and discharged. Conclusion: It is important to maintain a high index of suspicion to screen for carbapenemase-producing Enterobacteriaceae strains. Rapid identification of these strains and implementation of stringent procedures are the key to prevent major outbreaks in a hospital setting.

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“…Recent studies shed light on some risk factors for CR-Kp acquisition (5)(6)(7)(8). However, the importance of the prior use of antibiotics has been little investigated.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

Djordjevic

Folić

Gajovic

et al. 2018

Serbian Journal of Experimental and Clinical Research

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Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a major threat to patients in hospitals, increasing mortality, length of stay and costs. e aim of this study was to discover risk factors for the development of hospital infections (HIs) caused by CR-Kp. A prospective cohort study was conducted in the Medical-Surgical Intensive Care Unit of the Clinical Centre in Kragujevac, Kragujevac, Serbia, from January 1, 2011, to December 31, 2015 (OR=1.080; p=0.045); previous use of carbapenems (OR=7.005; p=0.044); previous use of ciprofl oxacin (OR=20.628; p=0.007) and previous use of metronidazole (OR=40.320; p=0.011 p=0.046), dužina primene antibiotske terapije pre nastanka bolničke infekcije (OR=1.080; p=0.045), prethodna upotreba karbapenema (OR=7.005; p=0.044), prethodna upotreba ciprofl oksacina (OR=20.628; p=0.007) i prethodna upotreba metronidazola (OR=40.320; p=0.011

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Impact of carbapenem resistance on the outcome of patients' hospital-acquired bacteraemia caused by Klebsiella pneumoniae

Cited by 134 publications

References 23 publications

Carbapenem-resistant Enterobacteriaceae in special populations: Solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies

Carbapenem-resistant Enterobacteriaceae in special populations: Solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies

Characteristics and management of Enterobacteriaceae harboring IMP-4 or IMP-8 carbapenemase in a tertiary hospital

Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

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