title: Carbapenem resistant Gram-negative bacteremia in an Indian intensive care unit: A review of the clinical profile and treatment outcome of 50 patients.
abstract: BACKGROUND
  Growing antimicrobial resistance and limited therapeutic options to treat carbapenem-resistant bacteremia prompted us to evaluate the clinical outcomes associated with healthcare-associated bacteremia.
  
  
  METHODS
  This was a retrospective observational study of carbapenem-resistant Gram-negative bacteremia performed at a tertiary care facility in Chennai, India between May 2011 and May 2012.
  
  
  RESULTS
  In our study, patients had mean 11.76 days of intensive care unit (ICU) care and mean time to onset of bacteremia was 6.4 days after admission. The commonest organism was Klebsiella pneumoniae (44%). Patients with combination treatment had lower mortality (44.8%) compared with colistin monotherapy (66.6%); (P = 0.35).
  
  
  CONCLUSIONS
  Carbapenem resistant bacteremia is a late onset infection in patients with antibiotic exposure in the ICU and carries a 30 days mortality of 60%; K. pneumoniae is the most common organism at our center. Two drug combinations appear to carry a lower mortality compared with monotherapy.
authors.affiliation: Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Ravikant
authors.initials: R
authors.lastname: Porwal
authors.affiliation: Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Ram
authors.initials: R
authors.lastname: Gopalakrishnan
authors.affiliation: Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: Naga Jawahar
authors.initials: NJ
authors.lastname: Rajesh
authors.affiliation: Department of Infectious Diseases, Apollo Hospitals, Chennai, Tamil Nadu, India.
authors.forename: V
authors.initials: V
authors.lastname: Ramasubramanian
keywords: Bacteremia in Indian intensive care unit; carbapenem resistant Gram-negative bacteremia; carbapenem resistant Klebsiella pneumoniae; multidrug-resistant bacteremia