ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Colistin Resistance in Carbapenem-Resistant Klebsiella pneumoniae: Laboratory Detection and Impact on Mortality.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03597841 (Turkish Prospective Cohort Study on Carbapenem Resistant Klebsiella Pneumonia Bacteremia), which is not on this map. Cited by 114 papers, 3 of them syntheses that pooled it.
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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.
Turkish Prospective Cohort Study on Carbapenem Resistant Klebsiella Pneumonia Bacteremia: a National Multicenter Observational Study
Who cites it
114 citing papers in PubMed, 3 syntheses or guidelines pooled it, 189 citations in OpenAlex.
- Fitness costs of mobilised colistin resistance gene 3 (mcr-3): systematic review, epidemiological study, and functional analysis.EBioMedicine · 2025Pooled it
- Guideline
- Triple combination antibiotic therapy for carbapenemase-producing Klebsiella pneumoniae: a systematic review.Annals of clinical microbiology and antimicrobials · 2017Pooled it
- Molecular and phenotypic profiles of carbapenem- and third-generation cephalosporin-resistant Klebsiella pneumoniae isolates from the fecal microbiota of pediatric patients with COVID-19.BMC microbiology · 2026Article
- Genomic analysis of antimicrobial resistance and virulence among gram-negative bloodstream isolates from Lebanon.Microbiology spectrum · 2026Article
- Dynamics of the Microbiome and Antibiotic Resistome in Hyper-Mesophilic Anaerobic Digestion of Cattle Manure Assisted with Granular Activated Carbon.ACS environmental Au · 2026Article
- Klebsiella pneumoniae in the global AMR: resistance mechanisms and genomic adaptation.World journal of microbiology & biotechnology · 2026Review
- Peptoid-based antimicrobial strategies against polymyxin-resistant Gram-negative bacteria.Journal of applied microbiology · 2026Article
- Emergence of Polymyxin Resistance Driven by a PhoQ Mutation in KPC-2-ProducingAntibiotics (Basel, Switzerland) · 2026Article
- Prevalence, clinical characteristics, and antibiotic resistance of carbapenem-resistant Klebsiella pneumoniae in a tertiary hospital in Türkiye (2023-2025).BMC microbiology · 2026Observational
- Silent Threat Evolution: Critically Important Carbapenem and Colistin Resistance Genes in the Natural Aquatic Environment.Antibiotics (Basel, Switzerland) · 2026Review
- Clinical Epidemiological Analysis of the Genotypic Spectrum and Mortality Risk in Carbapenem-ResistantThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Review
- Synergistic effects of colistin-based combinations against colistin and carbapenem-resistant Klebsiella pneumoniae isolated from nosocomial bloodstream infections.Scientific reports · 2025Article
- Molecular characterization of colistin resistance in carbapenem-resistantMicrobiology spectrum · 2025Article
- Observational
- A network analysis of carbapenem-resistant Klebsiella pneumoniae among healthcare facilities.Scientific reports · 2025Observational
- Bacteriophage treatment is effective against carbapenem-resistantAntimicrobial agents and chemotherapy · 2025Article
- Co-existence of antibiotic resistance and virulence factors in carbapenem resistant Klebsiella pneumoniae clinical isolates from Alexandria, Egypt.BMC microbiology · 2024Article
- Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit.Scientific reports · 2024Article
- Synergistic effect of fosfomycin and colistin against KPC-producing Klebsiella pneumoniae: pharmacokinetics-pharmacodynamics combined with transcriptomic approach.BMC microbiology · 2024Article
54 more citing papers are in PubMed but not listed here.
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Authors and funding
20 authors at 12 institutions in 2 countries.
Funding
Abstract
Background: Polymyxins including colistin are an important "last-line" treatment for infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKp). Increasing use of colistin has led to resistance to this cationic antimicrobial peptide. Methods: A cohort nested within the Consortium on Resistance against Carbapenems in Klebsiella pneumoniae (CRACKLE) was constructed of patients with infection, or colonization with CRKp isolates tested for colistin susceptibility during the study period of December, 2011 to October, 2014. Reference colistin resistance determination as performed by broth macrodilution was compared to results from clinical microbiology laboratories (Etest) and to polymyxin resistance testing. Each patient was included once, at the time of their first colistin-tested CRKp positive culture. Time to 30-day in-hospital all-cause mortality was evaluated by Kaplan-Meier curves and Cox proportional hazard modeling. Results: In 246 patients with CRKp, 13% possessed ColR CRKp. ColR was underestimated by Etest (very major error rate = 35%, major error rate = 0.4%). A variety of rep-PCR strain types were encountered in both the ColS and the ColR groups. Carbapenem resistance was mediated primarily by blaKPC-2 (46%) and blaKPC-3 (50%). ColR was associated with increased hazard for in-hospital mortality (aHR 3.48; 95% confidence interval, 1.73-6.57; P < .001). The plasmid-associated ColR genes, mcr-1 and mcr-2 were not detected in any of the ColR CRKp. Conclusions: In this cohort, 13% of patients with CRKp presented with ColR CRKp. The apparent polyclonal nature of the isolates suggests de novo emergence of ColR in this cohort as the primary factor driving ColR. Importantly, mortality was increased in patients with ColR isolates.
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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.