Infections caused by carbapenem-resistant Klebsiella pneumoniae among patients in intensive care units in Greece: a multi-centre study on clinical outcome and therapeutic options
| Autor: | I. Kioumis, Antonios Maragos, Helen Giamarellou, Flora Kontopidou, Panos Katerelos, Eleftheria Trikka-Graphakos, C. Valakis, H.C. Maltezou |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Adolescent medicine.drug_class medicine.medical_treatment Antibiotics Tigecycline intensive care unit beta-Lactam Resistance law.invention Young Adult law Internal medicine Intensive care Medicine Humans Intensive care medicine Aged Aged 80 and over Greece business.industry General Medicine Middle Aged Carbapenem-resistance mortality Intensive care unit Anti-Bacterial Agents Klebsiella Infections KPC Intensive Care Units Klebsiella pneumoniae Infectious Diseases Treatment Outcome Carbapenems Amikacin Colistin Gentamicin Female business Central venous catheter medicine.drug |
| Zdroj: | Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 20(2) |
| ISSN: | 1469-0691 |
| Popis: | Infections due to carbapenem-resistant Klebsiella pneumoniae (CR-KP) have emerged as a public health problem worldwide given their spread dynamics and the limited therapeutic options. Our aim was to study the clinical outcome of patients with CR-KP infections in relation to antimicrobial treatment. CR-KP infections that occurred in a 10-month period (September 2009 to June 2010) in patients admitted to 19 intensive care units all over Greece were studied. A total of 127 CR-KP infections were reported. Central venous catheter bacteraemia was the most frequent infection, followed by ventilator-associated pneumonia (39 (30.7%) and 35 (27.6%) cases, respectively). Resistance to colistin, tigecycline, gentamicin and amikacin was detected in 20%, 33%, 21% and 64% of isolates, respectively. Regarding treatment, 107 cases received active treatment, including 1 or ≥2 active antibiotics in 65 (60.7%) and 42 (39.3%) cases, respectively. The most frequent combination was colistin plus aminoglycoside and tigecycline plus aminoglycoside (17 and 11 cases, respectively). Forty-eight (45.2%) of the cases that received active treatment were considered clinical failures, with 23.5% mortality at 14 days. Logistic regression analysis revealed that age ≤55 years, non-immunocompromised patients and patients who received colistin had higher successful response rates, while patients ≤55 years old had lower mortality rates at 14 days after the introduction of active treatment. CR-KP infections are associated with a significant clinical failure rate. Colistin remains a valuable antimicrobial agent for treating these infections, while the rise of resistance to the last available antibiotics further limits treatment options. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text