| Autor: |
Lumbreras-Iglesias P; Traslational Microbiology Group, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain.; Department of Clinical Microbiology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain.; Hematological Malignancies Group, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain., Rodrigo-Arrazola E; Department of Clinical Microbiology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain., López-Amor L; Department of Intensive Care Medicine, San Agustín University Hospital (HUSA), 33401 Avilés, Spain., Fernández-Suárez J; Traslational Microbiology Group, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain.; Department of Clinical Microbiology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain., Rodicio MR; Traslational Microbiology Group, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain.; Department of Functional Biology, Microbiology Area, University of Oviedo, 33006 Oviedo, Spain., Fernández J; Traslational Microbiology Group, Health Research Institute of the Principality of Asturias (ISPA), 33011 Oviedo, Spain.; Department of Clinical Microbiology, Central University Hospital of Asturias (HUCA), 33011 Oviedo, Spain.; Department of Functional Biology, Microbiology Area, University of Oviedo, 33006 Oviedo, Spain.; Research & Innovation, Artificial Intelligence and Statistical Department, Pragmatech AI Solutions, 33001 Oviedo, Spain.; Biomedical Research Networking Center-Respiratory Diseases, 28029 Madrid, Spain. |
| Abstrakt: |
Bloodstream infections (BSI) caused by carbapenem-resistant Klebsiella pneumoniae are associated with high morbidity and mortality, and the therapy options available for their treatment are frequently scarce. The aim of this study was to analyze risk factors for 30-day mortality in patients with BSI caused by OXA-48-producing K. pneumoniae . The clinical and treatment features of the patients, who attended a single hospital over a five-year period, were retrospectively reviewed. The microbiological features, including the sequence types (ST) and the somatic (O) and capsular (K) antigens, as well as their resistance properties, comprising phenotypes and genetic background, were also considered. To identify the risk factors for 30-day mortality, uni- and multivariate statistical analyses were performed. The univariate analysis revealed statistically significant correlations for age, male gender, lower respiratory system infection, infection by ST147 isolates, and infection by isolates expressing the K64 antigen. The multivariate analysis, applied to variables yielding p -values close to or lower than 0.05 in the univariate analysis, confirmed gender, lower respiratory system infection, and infection with ST147 isolates, but not age or infection with K64 isolates, as risk factors for 30-day mortality. Moreover, the multivariate analysis showed that patients suffering from hematological malignancies or having been treated with inappropriate therapy, both having p -values slightly higher than 0.05 in the univariate analysis, exhibited significantly poorer outcomes in the multivariant analysis. The association of the ST147 clone with an increased risk of mortality is a novel finding that deserves further attention. Studies like the one presented here can certainly benefit the management of patients with nosocomial BSI caused by carbapenemase-producing K. pneumoniae . |
