ReviewMedicine2014
Klebsiella pneumoniae bloodstream infection: epidemiology and impact of inappropriate empirical therapy.
Review in Medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
62 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effect of antibiotic regimens for bloodstream infections caused by KPC-producing enterobacter: a network meta-analysis.Frontiers in medicine · 2026Pooled it
- Female Sex and Mortality in Patients With Gram-Negative Bacteremia: A Systematic Review and Meta-Analysis.JAMA network open · 2025Pooled it
- Effects of Inappropriate Administration of Empirical Antibiotics on Mortality in Adults With Bacteraemia: Systematic Review and Meta-Analysis.Frontiers in medicine · 2022Pooled it
- IGNITE4: Results of a Phase 3, Randomized, Multicenter, Prospective Trial of Eravacycline vs Meropenem in the Treatment of Complicated Intraabdominal Infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Trial
- Genomic characterization of the emerging multidrug-resistantMicrobiology spectrum · 2026Article
- Colonization of the gut byFrontiers in cellular and infection microbiology · 2026Article
- Synergistic effects of colistin-based combinations against colistin and carbapenem-resistant Klebsiella pneumoniae isolated from nosocomial bloodstream infections.Scientific reports · 2025Article
- A systematic analysis of various clonal lineages of colistin-resistant Klebsiella pneumoniae with mgrB mutations.Molecular biology reports · 2025Review
- Synergetic effects of Ulva lactuca and Pterocladiella capillacea on the multidrug-resistant Klebsiella pneumoniae.BMC microbiology · 2025Article
- Gram-negative bloodstream infections in six German university hospitals, 2016-2020: clinical and microbiological features.Infection · 2025Article
- A model for predicting bacteremia species based on host immune response.Frontiers in cellular and infection microbiology · 2025Article
- Colistin: Lights and Shadows of an Older Antibiotic.Molecules (Basel, Switzerland) · 2024Review
- Risk factors for bloodstream infection among patients admitted to an intensive care unit of a tertiary hospital of Shanghai, China.Scientific reports · 2024Article
- Photodynamic Therapy of LD4-Photosensitizer Attenuates the Acute Pneumonia Induced byACS pharmacology & translational science · 2024Article
- Impact of Immunosuppressed Status on Prognosis of Carbapenem-Resistant Organisms Bloodstream Infections.Infectious diseases and therapy · 2024Article
- Analysis of Blood Cultures from Major Burns Patients in a Tertiary Care Burn Unit in Oman.Sultan Qaboos University medical journal · 2024Article
- On the Potential of Relational Databases for the Detection of Clusters of Infection and Antibiotic Resistance Patterns.Antibiotics (Basel, Switzerland) · 2023Article
- Risk factors associated with inappropriate empirical antimicrobial treatment in bloodstream infections. A cohort study.Frontiers in pharmacology · 2023Article
- Molecular epidemiology, risk factors, and outcomes of carbapenem-resistantFrontiers in microbiology · 2023Article
- Clonal Spread of Carbapenem-Resistant Klebsiella pneumoniae Sequence Type 11 in Chinese Pediatric Patients.Microbiology spectrum · 2022Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Multidrug resistance associated with extended-spectrum beta-lactamase (ESBL) and Klebsiella pneumoniae carbapenemase (KPC) among K. pneumoniae is endemic in southern Europe. We retrospectively analyzed the impact of resistance on the appropriateness of empirical therapy and treatment outcomes of K. pneumoniae bloodstream infections (BSIs) during a 2-year period at a 1420-bed tertiary-care teaching hospital in northern Italy. We identified 217 unique patient BSIs, including 92 (42%) KPC-positive, 49 (23%) ESBL-positive, and 1 (0.5%) metallo-beta-lactamase-positive isolates. Adequate empirical therapy was administered in 74% of infections caused by non-ESBL non-KPC strains, versus 33% of ESBL and 23% of KPC cases (p < 0.0001). To clarify the impact of resistance on BSI treatment outcomes, we compared several different models comprised of non-antibiotic treatment-related factors predictive of patients' 30-day survival status. Acute Physiology and Chronic Health Evaluation (APACHE) II score determined at the time of positive blood culture was superior to other investigated models, correctly predicting survival status in 83% of the study cohort. In multivariate analysis accounting for APACHE II, receipt of inadequate empirical therapy was associated with nearly a twofold higher rate of death (adjusted hazard ratio 1.9, 95% confidence interval 1.1-3.4; p = 0.02). Multidrug-resistant K. pneumoniae accounted for two-thirds of all K. pneumoniae BSIs, high rates of inappropriate empirical therapy, and twofold higher rates of patient death irrespective of underlying illness.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.