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논문 기본 정보

자료유형
학술저널
저자정보
Seo Hyeonji (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Bae Seongman (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Kim Min-Jae (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Chong Yong Pil (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Kim Sung-Han (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Lee Sang-Oh (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Choi Sang-Ho (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Kim Yang Soo (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul) Jung Jiwon (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine Seoul)
저널정보
대한감염학회 Infection and Chemotherapy Infection and Chemotherapy 제53권 제3호
발행연도
2021.9
수록면
528 - 538 (11page)
DOI
10.3947/ic.2021.0083

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Background: Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacterales bacteremia is associated with significant mortality; however, no optimal antibiotic strategy is available. We aimed to evaluate the clinical outcomes according to the antibiotic regimens and identify risk factors for mortality in patients with KPC-producing K. pneumoniae and Escherichia coli bacteremia. Materials and Methods: This retrospective cohort study included all adult patients with monomicrobial bacteremia (KPC-producing K. pneumoniae or E. coli) between January 2011 and March 2021 at a 2,700-bed tertiary center. Results: Ninety-two patients were identified; 7 with E. coli bacteremia, and 85 with K. pneumoniae bacteremia. Thirty-day mortality was 38.0% (35/92). Non-survivors were more likely to have had nosocomial infection (88.6% vs. 63.2%, P = 0.01), high APACHE II scores (mean [interquartile range], 22.0 [14.0 - 28.0] vs. 14.0 [11.0 - 20.5], P <0.001), and septic shock (51.4% vs. 26.3%, P <0.001) and less likely to have been admitted to the surgical ward (5.7% vs. 22.8%, P = 0.04), undergone removal of eradicable foci (61.5% vs. 90.6%, P = 0.03), and received appropriate combination treatment (57.1% vs. 78.9%, P = 0.03) than survivors. No significant difference in mortality was observed according to combination regimens including colistin, aminoglycoside, and tigecycline. In multivariable analysis, high APACHE II scores (adjusted odds ratio [aOR], 1.14; 95% confidence interval [CI], 1.06 - 1.23, P <0.001), and appropriate definitive treatment (aOR, 0.25; CI, 0.08 - 0.74, P = 0.01) were independent risk factors for mortality. Conclusion: High APACHE II scores and not receiving appropriate definitive treatment were associated with 30-day mortality. Mortality did not significantly differ according to combination regimens with conventional drugs such as aminoglycoside and colistin.
#Klebsiella pneumoniae Carbapenemase #Mortality #Klebsiella pneumoniae #Escherichia coli #Bacteremia

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참고문헌 (32)

참고문헌 신청
Nordmann P / 2011 / Global spread of carbapenemase-producing Enterobacteriaceae / Emerg Infect Dis 17:1791~1798 google schola Ahn YS / 2021 / Epidemiology of carbapenem-resistant Enterobacteriaceae in Korea between 2018 and 2019 / Public Health Weekly Report 14:413~420 google schola Tumbarello M / 2012 / Predictors of mortality in bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: importance of combination therapy / Clin Infect Dis 55:943~950 google schola Tumbarello M / 2015 / Infections caused by KPC-producing Klebsiella pneumoniae: differences in therapy and mortality in a multicentre study / J Antimicrob Chemother 70:2133~2143 google schola Daikos GL / 2014 / Carbapenemaseproducing Klebsiella pneumoniae bloodstream infections: lowering mortality by antibiotic combination schemes and the role of carbapenems / Antimicrob Agents Chemother 58:2322~2328 google schola

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