Treatment Outcome of Bacteremia Due to KPC-Producing Klebsiella pneumoniae: Superiority of Combination Antimicrobial Regimens

Qureshi, Zubair A., Paterson, David L., Potoski, Brian A., Kilayko, Mary C., Sandovsky, Gabriel, Sordillo, Emilia, Polsky, Bruce, Adams-Haduch, Jennifer M. and Doi, Yohei (2012) Treatment Outcome of Bacteremia Due to KPC-Producing Klebsiella pneumoniae: Superiority of Combination Antimicrobial Regimens. Antimicrobial Agents and Chemotherapy, 56 4: 2108-2113. doi:10.1128/AAC.06268-11

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Author Qureshi, Zubair A.
Paterson, David L.
Potoski, Brian A.
Kilayko, Mary C.
Sandovsky, Gabriel
Sordillo, Emilia
Polsky, Bruce
Adams-Haduch, Jennifer M.
Doi, Yohei
Title Treatment Outcome of Bacteremia Due to KPC-Producing Klebsiella pneumoniae: Superiority of Combination Antimicrobial Regimens
Journal name Antimicrobial Agents and Chemotherapy   Check publisher's open access policy
ISSN 0066-4804
1098-6596
Publication date 2012-04
Sub-type Article (original research)
DOI 10.1128/AAC.06268-11
Open Access Status File (Publisher version)
Volume 56
Issue 4
Start page 2108
End page 2113
Total pages 6
Place of publication Washington, DC, United States
Publisher American Society for Microbiology
Collection year 2013
Language eng
Formatted abstract
Klebsiella pneumoniae producing Klebsiella pneumoniae carbapenemase (KPC) has been associated with serious infections and high mortality. The optimal antimicrobial therapy for infection due to KPC-producing K. pneumoniae is not well established.  We conducted a retrospective cohort study to evaluate the clinical outcome of patients with bacteremia caused by KPC-producing K. pneumoniae. A total of 41 unique patients with blood cultures growing KPC-producing K. pneumoniae were identified at two medical centers in the United States. Most of the infections were hospital acquired (32; 78%), while the rest of the cases were health care associated (9; 22%). The overall 28-day crude mortality rate was 39.0% (16/41). In the multivariate analysis, definitive therapy with a combination regimen was independently associated with survival (odds ratio, 0.07 [95% confidence interval,0.009 to 0.71], P=0.02). The 28-day mortality was 13.3% in the combination therapy group compared with 57.8% in the monotherapy group (P=0.01). The most commonly used combinations were colistin-polymyxin B or tigecycline combined with a carbapenem. The mortality in this group was 12.5% (1/8). Despite in vitro susceptibility, patients who received monotherapy with colistin-polymyxin B or tigecycline had a higher mortality of 66.7% (8/12). The use of combination therapy for definitive therapy appears to be associated with improved survival in bacteremia due to KPC-producing K. pneumoniae.
Keyword Carbapenem-Resistant Enterobacteriaceae
Colistin-Resistant
Infections
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2013 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 172 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 205 times in Scopus Article | Citations
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