Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit
Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKp) infections continue to be an important cause of mortality. In this retrospective study, the effect of carbapenem or colistin resistance on mortality in Klebsiella pneumoniae bacteremia and combined meropenem + colistin administration in CRKp...
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Nature Portfolio
2024-10-01
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| Online Access: | https://doi.org/10.1038/s41598-024-73786-x |
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| author | Cihan Semet Kadir Efe Halis Akalın Remzi İşçimen Nermin Kelebek Girgin Cüneyt Özakın Naci Cangül Ferda Kahveci |
| author_facet | Cihan Semet Kadir Efe Halis Akalın Remzi İşçimen Nermin Kelebek Girgin Cüneyt Özakın Naci Cangül Ferda Kahveci |
| author_sort | Cihan Semet |
| collection | DOAJ |
| description | Abstract Carbapenem-resistant Klebsiella pneumoniae (CRKp) infections continue to be an important cause of mortality. In this retrospective study, the effect of carbapenem or colistin resistance on mortality in Klebsiella pneumoniae bacteremia and combined meropenem + colistin administration in CRKp bacteremia was evaluated. In addition to that, a mathematical model is applied to explore the relationships between the resistance and mortality. A total of 139 adult patients diagnosed with K. pneumoniae bacteremia(73 carbapenem sensitive and 66 carbapenem resistant) between 01/01/2000 and 31/07/2019 were included in the study. The 30-day mortality in entire cohort were 19.4%. 30-day mortality was significantly higher in the carbapenem resistant-colistin sensitive group and in the carbapenem resistant-colistin resistant group compared to the carbapenem susceptible group. Meropenem + colistin combination was administered to 37 (95%) of carbapenem resistant–colistin sensitive (n = 39) and 25 (93%) of carbapenem resistant–colistin resistant patients(n = 27). Notably, mortality was not significantly affected regardless of whether CRKp was colistin sensitive and whether a high dose and prolonged infusion of meropenem was administered. Mortality is higher in carbapenem resistant Klebsiella pneumoniae bacteremia compared to carbapenem susceptible group. In cases of combined meropenem and colistin administration, high dose and prolonged infusion of meropenem is not superior to standard dose and infusion in both carbapenem resistant–colistin sensitive and carbapenem resistant–colistin resistant K. pneumoniae bacteremia. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-2c60ac1d9d3744e0843cb44389bed3fa2024-11-17T12:22:38ZengNature PortfolioScientific Reports2045-23222024-10-011411910.1038/s41598-024-73786-xOutcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unitCihan Semet0Kadir Efe1Halis Akalın2Remzi İşçimen3Nermin Kelebek Girgin4Cüneyt Özakın5Naci Cangül6Ferda Kahveci7Faculty of Medicine, Dept. of Infectious Diseases and Clinical Microbiology, Bursa Uludağ UnivFaculty of Medicine, Dept. of Medical Microbiology, Bursa Uludağ UnivFaculty of Medicine, Dept. of Infectious Diseases and Clinical Microbiology, Bursa Uludağ UnivFaculty of Medicine, Dept. of Anesthesiology and Reanimation ICU, Bursa Uludağ UnivFaculty of Medicine, Dept. of Anesthesiology and Reanimation ICU, Bursa Uludağ UnivFaculty of Medicine, Dept. of Medical Microbiology, Bursa Uludağ UnivFaculty of Arts and Science, Department of Mathematics, Bursa Uludağ UnivFaculty of Medicine, Dept. of Anesthesiology and Reanimation ICU, Bursa Uludağ UnivAbstract Carbapenem-resistant Klebsiella pneumoniae (CRKp) infections continue to be an important cause of mortality. In this retrospective study, the effect of carbapenem or colistin resistance on mortality in Klebsiella pneumoniae bacteremia and combined meropenem + colistin administration in CRKp bacteremia was evaluated. In addition to that, a mathematical model is applied to explore the relationships between the resistance and mortality. A total of 139 adult patients diagnosed with K. pneumoniae bacteremia(73 carbapenem sensitive and 66 carbapenem resistant) between 01/01/2000 and 31/07/2019 were included in the study. The 30-day mortality in entire cohort were 19.4%. 30-day mortality was significantly higher in the carbapenem resistant-colistin sensitive group and in the carbapenem resistant-colistin resistant group compared to the carbapenem susceptible group. Meropenem + colistin combination was administered to 37 (95%) of carbapenem resistant–colistin sensitive (n = 39) and 25 (93%) of carbapenem resistant–colistin resistant patients(n = 27). Notably, mortality was not significantly affected regardless of whether CRKp was colistin sensitive and whether a high dose and prolonged infusion of meropenem was administered. Mortality is higher in carbapenem resistant Klebsiella pneumoniae bacteremia compared to carbapenem susceptible group. In cases of combined meropenem and colistin administration, high dose and prolonged infusion of meropenem is not superior to standard dose and infusion in both carbapenem resistant–colistin sensitive and carbapenem resistant–colistin resistant K. pneumoniae bacteremia.https://doi.org/10.1038/s41598-024-73786-xKlebsiellaBacteremiaCarbapenem resistanceColistinMeropenem |
| spellingShingle | Cihan Semet Kadir Efe Halis Akalın Remzi İşçimen Nermin Kelebek Girgin Cüneyt Özakın Naci Cangül Ferda Kahveci Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit Scientific Reports Klebsiella Bacteremia Carbapenem resistance Colistin Meropenem |
| title | Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit |
| title_full | Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit |
| title_fullStr | Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit |
| title_full_unstemmed | Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit |
| title_short | Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit |
| title_sort | outcome of carbapenem or colistin resistant klebsiella pneumoniae bacteremia in the intensive care unit |
| topic | Klebsiella Bacteremia Carbapenem resistance Colistin Meropenem |
| url | https://doi.org/10.1038/s41598-024-73786-x |
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