Predictors of mortality in multidrug-resistant Klebsiella pneumoniae bloodstream infections.
The dramatic increase of antibiotic resistance in Klebsiella pneumoniae has been associated with fatal outcomes. First, bloodstream infections (BSIs) caused by extended-spectrum β-lactamases (ESBL) Enterobacteriaceae have been associated with treatment failure, more recently BSIs caused by carbapenem-resistant K. pneumoniae (CR-KP) have been reported to be fatal in approximately 50% of cases. Severity of underlying disease, intensive care unit stay at infection onset, infection with ESBL or CR-KP strain and delay in administration of appropriate therapy are among the most common risk factors for mortality in patients with K. pneumoniae BSI, while infection source control and early appropriate antimicrobial treatment have been associated with survival. Thus, risk assessment for ESBL and/or CR-KP is mandatory in patients with suspicion of K. pneumoniae BSI. Here, we examine current evidence regarding risk factors for mortality in patients with K. pneumoniae BSI and address the issue of a risk prediction model for CR-KP BSI.
Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Pierluigi
P
Viale
Maddalena
M
Giannella
Russell
R
Lewis
Emanuele Maria
EM
Trecarichi
Nicola
N
Petrosillo
Mario
M
Tumbarello
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D015780:Carbapenems / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000472:pathogenicity*; D015233:Models, Statistical; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D001618:beta-Lactamases / Q000378:metabolism
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases