Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies

  title={Outcomes of Carbapenem-Resistant Klebsiella pneumoniae Infection and the Impact of Antimicrobial and Adjunctive Therapies},
  author={Gopi Patel and Shirish S Huprikar and Stephanie H. Factor and Stephen G. Jenkins and David P. Calfee},
  journal={Infection Control \&\#x0026; Hospital Epidemiology},
  pages={1099 - 1106}
Background. Carbapenem-resistant Klebsiella pneumoniae is an emerging healthcare-associated pathogen. Objective. To describe the epidemiology of and clinical outcomes associated with carbapenem-resistant K. pneumoniae infection and to identify risk factors associated with mortality among patients with this type of infection. Setting. Mount Sinai Hospital, a 1,171-bed tertiary care teaching hospital in New York City. Design. Two matched case-control studies. Methods. In the first matched case… 

The Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae Colonization and Infection among Long-Term Acute Care Hospital Residents

An improved understanding of carbapenem-resistant Klebsiella pneumoniae (CRKP) in long-term acute care hospitals (LTACHs) is needed, including targeted surveillance screening of high-risk patients and effective antibiotic stewardship measures.

A retrospective study of risk factors for carbapenem-resistant Klebsiella pneumoniae acquisition among ICU patients.

Exposure to carbapenems is an independent risk factor for CRKP infection among intensive care unit (ICU) patients and patients with this clinical factor should be targeted for interventions to reduce the subsequent risk of infection.

Risk Factors and Clinical Impact of Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae

Limiting use of certain antimicrobials, specifically fluoroquinolones and cephalosporins, use may be effective strategies for prevention and infection control.

Carbapenem Resistance Among Klebsiella pneumoniae Isolates Risk Factors, Molecular Characteristics, and Susceptibility Patterns

Almost all CRKP isolates were resistant to all antibiotics, except to Colistin, gentamicin, and tigecycline, which suggests these isolates are resistant to virtually all commonly used antibiotics.

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Success of an Infection Control Program to Reduce the Spread of Carbapenem-Resistant Klebsiella pneumoniae

The comprehensive intervention that combined intensified infection control measures with routine rectal surveillance cultures was helpful in reducing the incidence of carbapenem-resistant K. pneumoniae in an intensive care unit where strains producing the carbAPenemase KPC were endemic.

Outbreak of Carbapenem-Resistant Klebsiella pneumoniae in Puerto Rico Associated with a Novel Carbapenemase Variant

Enhanced surveillance for CRKP colonization and intensified infection control measures that include limiting the physical distribution of patients can reduceCRKP transmission during an outbreak.

Clinical Characteristics of Carbapenem-resistant Klebsiella pneumoniae Infections in Ill and Colonized Children in Colombia

CRKp infections have high mortality in children and usually occur in children with comorbidities, prolonged hospital stay and prior antibiotic exposure, and combined therapy with meropenem-containing regimens seems to be the best option in severely ill children.

Outcome of carbapenem resistant Klebsiella pneumoniae bloodstream infections.

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Patients with carbapenem-resistant K. pneumoniae had higher rates of prior antimicrobial exposure, other nosocomial infections, and use of invasive devices; and independent risk factors for infection-related mortality were Pitt bacteraemia score, Charlson score and carbAPenem resistance.



Risk factors of carbapenem-resistant Klebsiella pneumoniae infections: a matched case control study.

The data suggest that prior exposure to fluoroquinolones and antipseudomonal penicillins are independent risk factors for the development of CRKp infections.

Predictors of Carbapenem-Resistant Klebsiella pneumoniae Acquisition among Hospitalized Adults and Effect of Acquisition on Mortality

CRKP affects patients with poor functional status, an ICU stay, and antibiotic exposure and is an independent predictor of death.

Tigecycline for Treatment of Pneumonia and Empyema Caused by Carbapenemase‐Producing Klebsiella pneumoniae

Clinicians should be aware of the potential occurrence of this treatment‐emergent MIC increase, especially in the setting of sustained tigecycline therapy, and the emergence of carbapenem‐resistant Enterobacteriaceae reinforces the importance of antibiotic stewardship and strict infection control practices.

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Imipenem resistance in Klebsiella may occur when this agent is used for treatment of infection due to ceftazidine- and aminoglycoside-resistant strains.

Risk factors for the acquisition of carbapenem-resistant Klebsiella pneumoniae among hospitalized patients.

The results suggest that the nosocomial isolation of CRKP is strongly favored by the selection pressure of carbapenem.

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Epidemic outbreaks of infection with ESBL-producing E. coli and K. pneumoniae should emphasize judicious use of all antibiotics as well as barrier precautions to reduce spread.

Evolution of antimicrobial resistance among Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae in Brooklyn, NY.

Hospitals in the authors' region have been beset with antimicrobial-resistant Gram-negative bacteria, and Klebsiella pneumoniae has rapidly emerged as the most common multidrug-resistant pathogen.

Impact of Extended-Spectrum β-Lactamase–Producing Escherichia coli and Klebsiella Species on Clinical Outcomes and Hospital Costs: A Matched Cohort Study

The cost of non–urinary tract infections caused by ESBL-EK was 1.7 times the cost ofNon–urinal tract infections causing by non-ESBL producers, and prompt recognition and appropriate antimicrobial selection may minimize this ESBL -related impact on hospital costs.

Carbapenemase-producing Klebsiella pneumoniae in Brooklyn, NY: molecular epidemiology and in vitro activity of polymyxin B and other agents.

The most consistently active agents in vitro were tigecycline and polymyxin B, particularly when the latter was combined with rifampicin, and the clinical efficacy of these agents remains to be determined.

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Methicillin resistance is independently associated with increased mortality and hospital charges among patients with S. aureus SSI and has a greater duration of hospitalization after infection.