ArticleIntensive care medicine2018
Mortality attributable to different Klebsiella susceptibility patterns and to the coverage of empirical antibiotic therapy: a cohort study on patients admitted to the ICU with infection.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Analysis of risk factors for mortality from carbapenem-resistantTranslational pediatrics · 2025Article
- Prognostic factors and clinical outcomes in Fournier's Gangrene: a retrospective study of 35 patients.BMC infectious diseases · 2024Article
- Antimicrobial Multidrug Resistance: Clinical Implications for Infection Management in Critically Ill Patients.Microorganisms · 2023Review
- Clinical Outcomes and Risk Factors for Death following Carbapenem-Resistant Klebsiella pneumoniae Infection in Solid Organ Transplant Recipients.Microbiology spectrum · 2023Article
- Clinical Efficacy, Antibiotic Resistance Genes, Virulence Factors and Outcome of Hospital-Acquired Pneumonia Induced byInfection and drug resistance · 2022Article
- Comparison of therapy with β-lactam/β-lactamase inhibitor combinations or carbapenems for bacteraemia of nonurinary source caused by ESBL-producing Escherichia coli or Klebsiella pneumoniae.Annals of clinical microbiology and antimicrobials · 2021Article
- Association between mortality and highly antimicrobial-resistant bacteria in intensive care unit-acquired pneumonia.Scientific reports · 2021Observational
- Characteristics and Clinical Implications of Carbapenemase-Producing Klebsiella pneumoniae Colonization and Infection, Italy.Emerging infectious diseases · 2021Article
- Effect on 30-day mortality and duration of hospitalization of empirical antibiotic therapy in CRGNB-infected pneumonia.Annals of clinical microbiology and antimicrobials · 2021Article
- An Outbreak of Carbapenem-ResistantFrontiers in cellular and infection microbiology · 2021Article
- Time to blood, respiratory and urine culture positivity in the intensive care unit: Implications for de-escalation.SAGE open medicine · 2021Article
- A risk score based on pediatric sequential organ failure assessment predicts 90-day mortality in children with Klebsiella pneumoniae bloodstream infection.BMC infectious diseases · 2020Article
- Maipomycin A, a Novel Natural Compound With Promising Anti-biofilm Activity Against Gram-Negative Pathogenic Bacteria.Frontiers in microbiology · 2020Article
- Focus on infection.Intensive care medicine · 2019Article
- Rationalizing antimicrobial therapy in the ICU: a narrative review.Intensive care medicine · 2019Review
- Correction to: Treatment and mortality of Klebslella pneumoniae infections in critically ill patients: should we do and predict them better?Intensive care medicine · 2018Article
- Treatment and mortality of Klebslella pneumoniae infections in critically ill patients: should we do and predict them better?Intensive care medicine · 2018Article
- Pathogenesis and therapeutic opportunities of gut microbiome dysbiosis in critical illness.Gut microbesReview
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13 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: multi-susceptible Klebsiella (MS-K), extended-spectrum cephalosporin-resistant, but carbapenem-susceptible Klebsiella (ESCR-CS-K), and carbapenem-resistant Klebsiella (CR-K).
methodsWe developed a prognostic model to predict hospital mortality in patients with infection on admission to the intensive care units (ICUs), and assessed its calibration in the subgroups of interest: patients with infections due to MS-K, ESCR-CS-K, CR-K. We assessed the calibration of the model also in ESCR-CS-K treated empirically with carbapenems and with piperacillin-tazobactam.
resultsA total of 13,292 adults with an ongoing infection were admitted to 137 Italian ICUs in 2012-2013. Of 801 Klebsiella spp. infected patients, 451 had MS-K, 116 ESCR-CS-K, and 234 CR-K. The prognostic model calibrated well for the MS-K and ESCR-CS-K subgroups. In the CR-K subgroup there were more deaths than predicted (standardized mortality ratio 1.20; 95% CI 1.08-1.31), indicating a negative prognostic role of the infection, mainly in the medium and high risk-of-death patients. When infection was caused by ESCR-CS-K, treatment with piperacillin-tazobactam increased adjusted mortality among the most severe patients (similarly to CR-K), while treatment with carbapenems did not (similarly to MS-K).
conclusionsIn low risk-of-death patients admitted to the ICU with a Klebsiella spp. infection, the appropriateness of empirical antibiotic therapy seemed uninfluential to eventual mortality, while it appeared to be crucial in high-risk ones. The use of piperacillin-tazobactam may be inappropriate in severe patients with ESCR-CS-K infection. CR-K is associated to a significant 20% increase of adjusted mortality, only for patients at higher risk of death.
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