English  |  正體中文  |  简体中文  |  Items with full text/Total items : 12145/12927 (94%)
Visitors : 848853      Online Users : 1370
RC Version 6.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
Scope Tips:
  • please add "double quotation mark" for query phrases to get precise results
  • please goto advance search for comprehansive author search
    •  Adv. Search
    Home ‧ Login ‧ Upload ‧ Help ‧ About ‧ Administer Goto mobile version


    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/10931


    Title: Predictors of mortality in hospitalized patients with carbapenem-resistant Klebsiella pneumoniae bacteriuria
    Authors: Chuang, C;Su, CF;Lin, YT;Wang, FD;Chuang, YC;Siu, LK;Fung, CP
    Contributors: National Institute of Infectious Diseases and Vaccinology
    Abstract: Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has been increasingly reported worldwide, but few studies address the clinical significance and outcome of antimicro-bial treatment in CRKP bacteriuria. Methods: We retrospectively collected clinical and microbiological data of patients with monomicrobial CRKP bacteriuria from 16 hospitals in Taiwan during 2013 to 2014. Carbapenem resistance was defined as a minimum inhibitory concentration (MIC) of ≥2 mg/L for imipenem or meropenem. The resistance mechanisms were analyzed. Critically ill patients were those with an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥ 20. Tigecycline was considered as inappropriate therapy regardless of MIC due to low urine concentration. Multivariate Cox regression analysis was used to determine independent risk factors of 14-day and 28-day mortality. Subgroup analysis for critically ill and non-critically ill patients were performed. Results: Of the 126 hospitalized patients with CRKP bacteriuria, 53 had genes that encoded carbapenemase: KPC-2 (n = 43), KPC-17 (n = 7), VIM-1 (n = 1), IMP-8 (n = 1) and OXA-48 (n = 1). The 14-day and 28-day mortality were 12.7% and 23.0%, respectively. Critically ill patients (n = 53, 42.1%) had significantly higher mortality to non-critically ill patients. Appropriate antimicrobial therapy was used in 33 patients (26.2%). In the multivariate Cox analysis, APACHI II score was the only independent risk factor for 14-day mortality (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.08–1.22; P < 0.001). APACHI II score (HR, 1.11; 95% CI, 1.06–1.16; P < 0.001) and immunocompomised state (HR, 3.27; 95% CI, 1.21–8.81; P = 0.019) were the independent risk factors for 28-day mortality. We further stratified patients into critically ill and non-critically ill group, and found appropriate antimicrobial therapy was not associated with survival benefit in both groups. Conclusion: Host factors were the predictors for mortality in patients with CRKP bacteriuria. Antimicrobial treatment was not associated with survival benefit in either critically ill or non-critically ill patients. The findings may provide some insight on future antibiotic stewardship interventions.
    Date: 2017-11
    Relation: International Journal of Antimicrobial Agents. 2017 Nov;50(Suppl. 2):S242.
    Link to: http://dx.doi.org/10.1016/S0924-8579(17)30423-5
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0924-8579&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000416028900612
    Appears in Collections:[蕭樑基] 會議論文/會議摘要

    Files in This Item:

    File SizeFormat
    ISI000416028900612.pdf84KbAdobe PDF304View/Open


    All items in NHRI are protected by copyright, with all rights reserved.

    Related Items in TAIR

    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - Feedback