Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)

Detalhes bibliográficos
Autor(a) principal: Boattini, Matteo
Data de Publicação: 2023
Outros Autores: Bianco, Gabriele, Bastos, Paulo, Comini, Sara, Corcione, Silvia, Almeida, André, Costa, Cristina, De Rosa, Francesco Giuseppe, Cavallo, Rossana
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10362/160770
Resumo: Funding Information: Open access funding provided by Università degli Studi di Torino within the CRUI-CARE Agreement. This research was supported by EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT). Publisher Copyright: © 2023, The Author(s).
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spelling Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)Bloodstream infectionCeftazidime/avibactam resistanceKlebsiella pneumoniaeKPCMortalitySepsisMicrobiology (medical)Infectious DiseasesSDG 3 - Good Health and Well-beingFunding Information: Open access funding provided by Università degli Studi di Torino within the CRUI-CARE Agreement. This research was supported by EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT). Publisher Copyright: © 2023, The Author(s).Introduction: Ceftazidime/avibactam-resistance in Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) is a topic of great interest for epidemiological, diagnostic, and therapeutical reasons. However, data on its prevalence and burden on mortality in patients with bloodstream infection (BSI) are lacking. This study was aimed at identifying risk factors for mortality in patients suffering from ceftazidime/avibactam-resistant KPC-Kp BSI. Methods: An observational retrospective study (January 2018–December 2022) was conducted at a tertiary hospital including all consecutive hospitalized adult patients with a ceftazidime/avibactam-resistant KPC-Kp BSI. Data on baseline clinical features, management, and admission outcomes were analyzed. Results: Over the study period, among all the KPC-Kp BSI events recorded, 38 (10.5%) were caused by ceftazidime/avibactam-resistant KPC-Kp strains, 37 events being finally included. The ceftazidime/avibactam-resistant KPC-Kp strains revealed susceptibility restoration to at least one carbapenem in more than 60% of cases. In-hospital and 30-day all-cause mortality rates were 22% and 16.2%, respectively. Non-survivors suffered from more baseline comorbidities and experienced a more severe ceftazidime/avibactam-resistant KPC-Kp BSI presentation (i.e., both the Pitt Bacteremia and INCREMENT-CPE scores were significantly higher). Presenting with a higher Charlson Comorbidity Index, chronic kidney disease—KDIGO stage 3A or worse—having recently gone through renal replacement therapy, having suffered from an acute kidney injury following the ceftazidime/avibactam-resistant KPC-Kp BSI, and being admitted for cardiac surgery were the strongest predictors of mortality. Conclusion: Ceftazidime/avibactam resistance in KPC-Kp BSI easily emerged in our highly KPC-Kp endemic area with remarkable mortality rates. Our findings might provide physicians possibly actionable information when managing patients with a ceftazidime/avibactam-resistant KPC-Kp BSI.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNBoattini, MatteoBianco, GabrieleBastos, PauloComini, SaraCorcione, SilviaAlmeida, AndréCosta, CristinaDe Rosa, Francesco GiuseppeCavallo, Rossana2023-11-30T22:21:17Z2024-012024-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/160770eng0934-9723PURE: 77408546https://doi.org/10.1007/s10096-023-04712-8info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:43:33Zoai:run.unl.pt:10362/160770Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:58:13.258156Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
title Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
spellingShingle Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
Boattini, Matteo
Bloodstream infection
Ceftazidime/avibactam resistance
Klebsiella pneumoniae
KPC
Mortality
Sepsis
Microbiology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
title_short Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
title_full Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
title_fullStr Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
title_full_unstemmed Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
title_sort Prevalence and mortality of ceftazidime/avibactam-resistant KPC-producing Klebsiella pneumoniae bloodstream infections (2018–2022)
author Boattini, Matteo
author_facet Boattini, Matteo
Bianco, Gabriele
Bastos, Paulo
Comini, Sara
Corcione, Silvia
Almeida, André
Costa, Cristina
De Rosa, Francesco Giuseppe
Cavallo, Rossana
author_role author
author2 Bianco, Gabriele
Bastos, Paulo
Comini, Sara
Corcione, Silvia
Almeida, André
Costa, Cristina
De Rosa, Francesco Giuseppe
Cavallo, Rossana
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Boattini, Matteo
Bianco, Gabriele
Bastos, Paulo
Comini, Sara
Corcione, Silvia
Almeida, André
Costa, Cristina
De Rosa, Francesco Giuseppe
Cavallo, Rossana
dc.subject.por.fl_str_mv Bloodstream infection
Ceftazidime/avibactam resistance
Klebsiella pneumoniae
KPC
Mortality
Sepsis
Microbiology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
topic Bloodstream infection
Ceftazidime/avibactam resistance
Klebsiella pneumoniae
KPC
Mortality
Sepsis
Microbiology (medical)
Infectious Diseases
SDG 3 - Good Health and Well-being
description Funding Information: Open access funding provided by Università degli Studi di Torino within the CRUI-CARE Agreement. This research was supported by EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases (Project no. PE00000007, INF-ACT). Publisher Copyright: © 2023, The Author(s).
publishDate 2023
dc.date.none.fl_str_mv 2023-11-30T22:21:17Z
2024-01
2024-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/160770
url http://hdl.handle.net/10362/160770
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 0934-9723
PURE: 77408546
https://doi.org/10.1007/s10096-023-04712-8
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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