Impact of KPC Production and High-Level Meropenem Resistance on All-Cause Mortality of Ventilator-Associated Pneumonia in Association with Klebsiella pneumoniae
Carbapenemase-producing and specifically carbapenemase (KPC)-producing (KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-Kp is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is a...
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| Veröffentlicht in: | Antimicrobial agents and chemotherapy 2020-05, Vol.64 (6) |
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| creator | Rivera-Espinar, Francisco Machuca, Isabel Tejero, Rocio Rodríguez, Jorge Mula, Ana Marfil, Eduardo Cano, Ángela Gutiérrez-Gutiérrez, Belén Rodríguez, Marina Pozo, Juan Carlos De la Fuente, Carmen Rodriguez-Baño, Jesús Martínez-Martínez, Luis León, Rafael Torre-Cisneros, Julian |
| description | Carbapenemase-producing
and specifically
carbapenemase (KPC)-producing
(KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-Kp is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than that caused by carbapenem-susceptible isolates. This is a retrospective cohort study of patients with VAP due to
from a 35-bed polyvalent intensive care unit in a university hospital (>40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression). We analyze 69 cases of
VAP, of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/ml). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.46 to 3.41). Adequate targeted therapy (HR, 0.03; 95% CI, |
| doi_str_mv | 10.1128/AAC.02164-19 |
| format | Article |
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and specifically
carbapenemase (KPC)-producing
(KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-Kp is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than that caused by carbapenem-susceptible isolates. This is a retrospective cohort study of patients with VAP due to
from a 35-bed polyvalent intensive care unit in a university hospital (>40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression). We analyze 69 cases of
VAP, of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/ml). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.46 to 3.41). Adequate targeted therapy (HR, 0.03; 95% CI, <0.01 to 0.23) was associated with all-cause mortality. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible
when appropriate treatment is used.</description><identifier>ISSN: 0066-4804</identifier><identifier>EISSN: 1098-6596</identifier><identifier>DOI: 10.1128/AAC.02164-19</identifier><identifier>PMID: 32205347</identifier><language>eng</language><publisher>United States: American Society for Microbiology</publisher><subject>Clinical Therapeutics</subject><ispartof>Antimicrobial agents and chemotherapy, 2020-05, Vol.64 (6)</ispartof><rights>Copyright © 2020 American Society for Microbiology.</rights><rights>Copyright © 2020 American Society for Microbiology. 2020 American Society for Microbiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a418t-506921f2852e02d22d69c3b6f35fac30eb562e872297ce7bef58f89a75279ee73</citedby><cites>FETCH-LOGICAL-a418t-506921f2852e02d22d69c3b6f35fac30eb562e872297ce7bef58f89a75279ee73</cites><orcidid>0000-0001-6732-9001</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269473/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7269473/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32205347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rivera-Espinar, Francisco</creatorcontrib><creatorcontrib>Machuca, Isabel</creatorcontrib><creatorcontrib>Tejero, Rocio</creatorcontrib><creatorcontrib>Rodríguez, Jorge</creatorcontrib><creatorcontrib>Mula, Ana</creatorcontrib><creatorcontrib>Marfil, Eduardo</creatorcontrib><creatorcontrib>Cano, Ángela</creatorcontrib><creatorcontrib>Gutiérrez-Gutiérrez, Belén</creatorcontrib><creatorcontrib>Rodríguez, Marina</creatorcontrib><creatorcontrib>Pozo, Juan Carlos</creatorcontrib><creatorcontrib>De la Fuente, Carmen</creatorcontrib><creatorcontrib>Rodriguez-Baño, Jesús</creatorcontrib><creatorcontrib>Martínez-Martínez, Luis</creatorcontrib><creatorcontrib>León, Rafael</creatorcontrib><creatorcontrib>Torre-Cisneros, Julian</creatorcontrib><title>Impact of KPC Production and High-Level Meropenem Resistance on All-Cause Mortality of Ventilator-Associated Pneumonia in Association with Klebsiella pneumoniae</title><title>Antimicrobial agents and chemotherapy</title><addtitle>Antimicrob Agents Chemother</addtitle><addtitle>Antimicrob Agents Chemother</addtitle><description>Carbapenemase-producing
and specifically
carbapenemase (KPC)-producing
(KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-Kp is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than that caused by carbapenem-susceptible isolates. This is a retrospective cohort study of patients with VAP due to
from a 35-bed polyvalent intensive care unit in a university hospital (>40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression). We analyze 69 cases of
VAP, of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/ml). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.46 to 3.41). Adequate targeted therapy (HR, 0.03; 95% CI, <0.01 to 0.23) was associated with all-cause mortality. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible
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and specifically
carbapenemase (KPC)-producing
(KPC-Kp) are rapidly spreading worldwide. The prognosis of ventilator-associated pneumonia (VAP) caused by KPC-Kp is not well known. Our study tries to assess whether ventilator-associated pneumonia caused by a KPC-Kp strain is associated with higher all-cause mortality than that caused by carbapenem-susceptible isolates. This is a retrospective cohort study of patients with VAP due to
from a 35-bed polyvalent intensive care unit in a university hospital (>40,000 annual admissions) between January 2012 and December 2016. Adjusted multivariate analysis was used to study the association of KPC-Kp with 30-day all-cause mortality (Cox regression). We analyze 69 cases of
VAP, of which 39 were produced by a KPC-Kp strain with high-level resistance to meropenem (MIC > 16 mg/ml). All-cause mortality at 30 days was 41% in the KPC-Kp group (16/39) and 33.3% in the carbapenem-susceptible cases (10/30). KPC-Kp etiology was not associated with higher mortality when controlled for confounders (adjusted hazard ratio [HR], 1.25; 95% confidence interval [CI], 0.46 to 3.41). Adequate targeted therapy (HR, 0.03; 95% CI, <0.01 to 0.23) was associated with all-cause mortality. Assuming the limitations due to the available sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPs caused by carbapenem-susceptible
when appropriate treatment is used.</abstract><cop>United States</cop><pub>American Society for Microbiology</pub><pmid>32205347</pmid><doi>10.1128/AAC.02164-19</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6732-9001</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central; EZB Electronic Journals Library |
| subjects | Clinical Therapeutics |
| title | Impact of KPC Production and High-Level Meropenem Resistance on All-Cause Mortality of Ventilator-Associated Pneumonia in Association with Klebsiella pneumoniae |
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