RT Journal Article
T1 Impact of KPC Production and High-Level Meropenem Resistance on All-Cause Mortality of Ventilator-Associated Pneumonia in Association with Klebsiella pneumoniae.
A1 Rivera-Espinar, Francisco
A1 Machuca, Isabel
A1 Tejero, Rocio
A1 Rodriguez, Jorge
A1 Mula, Ana
A1 Marfil, Eduardo
A1 Cano, Angela
A1 Gutierrez-Gutierrez, Belen
A1 Rodriguez, Marina
A1 Pozo, Juan Carlos
A1 De la Fuente, Carmen
A1 Rodriguez-Baño, Jesus
A1 Martinez-Martinez, Luis
A1 Leon, Rafael
A1 Torre-Cisneros, Julian
K1 KPC
K1 Klebsiella pneumoniae
K1 Mortality
K1 Ventilator-associated pneumonia
AB Carbapenemase-producing Enterobacterales and specifically Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (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 K. pneumoniae 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 K. pneumoniae 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, 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 K. pneumoniae 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,  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 to0.23) was associated with all-cause mortality. Assuming the limitations due to theavailable sample size, the prognosis of VAP caused by KPC-Kp is similar to VAPscaused by carbapenem-susceptible K. pneumoniae when appropriate treatment isused.
PB American Society for Microbiology
YR 2020
FD 2020-03-08
LK http://hdl.handle.net/10668/15276
UL http://hdl.handle.net/10668/15276
LA en
NO Rivera-Espinar F, Machuca I, Tejero R, Rodríguez J, Mula A, Marfil E, et al. Impact of KPC Production and High-Level Meropenem Resistance on All-Cause Mortality of Ventilator-Associated Pneumonia in Association with Klebsiella pneumoniae. Antimicrob Agents Chemother. 2020 May 21;64(6):e02164-19
DS RISalud
RD Apr 7, 2025