Characteristics and outcomes of intensive care unit patients with carbapenem-resistant Klebsiella pneumoniae bacteraemia
Abstract number: P1273
Vardakas K., Matthaiou D., Antupa E., Pappas E., Kechagioglou G., Koteli A., Antoniadou E.
Background: Carbapenems are frequently used to treat infections due to extended-spectrum b-lactamase-producing Klebsiella pneumoniae. Thus, the emergence of infections due to carbapenem-resistant K. pneumoniae (CRKp) is a major public health concern.
Objective: To study the characteristics and outcomes of intensive care unit patients with carbapenem resistant K. pneumoniae (CRKp) bacteremia.
Methods: A retrospective cohort of patients requiring ICU treatment. The study was conducted in an 8-bed ICU between January 2006 and September 2009.
Results: During the study period 56 patients were diagnosed with CRKp bacteremia. The mean age of patients was 65.8±14.3 years. Thirty-two (57%) were males. The mean APACHE II score was 18.1±7.0. The median duration of hospital stay till bacteremia was 14.5 days. Twenty-nine patients (52%) had bacteremia of unknown origin, 17 (30%) had bacteremia secondary to other infections, and 10 (18%) had catheter-related bacteremia. Thirty-seven (66%) and 22 (39%) patients had previous and concurrent infections, respectively. Forty two (75%) patients died. The univariate analysis showed that APACHE II score (p = 0.01), cardiovascular disease (p = 0.03), red blood cell transfusion (p = 0.02), shock (p = 0.01) and acidosis (p = 0.04) immediately after the isolation of CRKp were the factors associated with death. None of these variables was an independent predictor of outcome in the multivariate analysis. Correct empirical treatment (p = 0.02) and successful outcome of the infection (p < 0.001) were the factors associated with survival.
Conclusions: Bacteremia due to CRKp in the ICU is associated with high mortality. Empirical treatment should include coverage against CRKp in ICUs with high prevalence of the infection.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
|Back to top|