ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2021
Colistin resistance increases 28-day mortality in bloodstream infections due to carbapenem-resistant Klebsiella pneumoniae.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Pooled it
- Epidemiological characteristics and risk factors associated with bacteremia caused by intrinsically colistin-resistant gram-negative microorganisms: a case-control study.BMC infectious diseases · 2026Article
- Clinical outcomes and mortality in carbapenem-resistant versus susceptible Klebsiella pneumoniae bloodstream infections in intensive care units.BMC infectious diseases · 2026Article
- Impact of Oxacillinase-48 (OXA-48) and New Delhi Metallo-β-Lactamase (NDM) Co-existence on Mortality in Critically Ill Patients withJournal of clinical practice and research · 2026Article
- Observational
- Risk Factors and Prognosis of Polymyxin- and Carbapenem-Resistant Enterobacteriaceae Infections: A Propensity-Matched Real-World Study.Microorganisms · 2025Article
- Impact of an antimicrobial stewardship program on colistin resistance in a tertiary care hospital in Pakistan: a quasi-experimental study.GMS infectious diseases · 2025Article
- Retrospective Case-Control Study of Risk Factors for Carbapenem-ResistantPathogens (Basel, Switzerland) · 2024Article
- A nosocomial outbreak of colistin and carbapenem-resistant hypervirulent Klebsiella pneumoniae in a large teaching hospital.Scientific reports · 2024Article
- Outcome of carbapenem or colistin resistant Klebsiella pneumoniae bacteremia in the intensive care unit.Scientific reports · 2024Article
- Resistance Genes and Mortality in Carbapenem-resistantBalkan medical journal · 2024Observational
- Retrospective analysis of molecular characteristics, risk factors, and outcomes in carbapenem-resistant Klebsiella pneumoniae bloodstream infections.BMC microbiology · 2024Observational
- Treatment Strategies of Colistin ResistanceAntibiotics (Basel, Switzerland) · 2024Review
- Epidemiology and mortality outcome of carbapenem- and colistin-resistantIJID regions · 2023Article
- Risk Factors and Outcomes for Isolation with Polymyxin B-Resistant Enterobacterales from 2018-2022: A Case-Control Study.Infection and drug resistance · 2023Article
- Multicenter Genomic Analysis of Carbapenem-Resistant Klebsiella pneumoniae from Bacteremia in China.Microbiology spectrum · 2022Article
- Polymyxin and lipopeptide antibiotics: membrane-targeting drugs of last resort.Microbiology (Reading, England) · 2022Review
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Authors and funding
14 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mortality due to K. pneumoniae bacteremia is on rise, particularly in regions with high rates of carbapenem and colistin resistance. We aimed to define risk factors for colistin resistance and its impact on mortality. Patients diagnosed with "carbapenem-resistant K. pneumoniae (CRKp)" bacteremia between 2014 and 2018 were divided into two groups as "colistin susceptible (ColS)" and "colistin resistant (ColR)" based on broth microdilution method. Retrospective case-control study was conducted to compare characteristics and outcomes. Multiple logistic regression model was used to define independent risk factors for acquired colistin resistance and Cox proportional hazard model for 28-day mortality. A total of 82 patients (39 ColS and 43 ColR) were included. Mean age was 61.5 years, and 50 (61%) were male. Colistin resistance was significantly increased with duration of hospital stay (p = 0.007) and prior colistin use (p = 0.007). Overall, the 28-day mortality rate was 66%. Age (p = 0.014) and colistin resistance significantly increased 28-day (p = 0.009) mortality. Microbiological response to treatment within 7 days favors survival. PFGE analysis revealed an outbreak with K. pneumoniae ST78 and ST45 clones. Patients treated with combined antimicrobials had significantly lower 28-day mortality (p = 0.045) in comparison to monotherapy. However, types of combinations did not show significant superiority on each other. Colistin resistance increases 28-day mortality in CRKp bacteremia. Although combined regimens are more effective than monotherapy, existing antibacterial combinations have no apparent superiority to each other. New treatment options are pivotal.
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