ArticleBMC infectious diseases2021
Reduced mortality from KPC-K.pneumoniae bloodstream infection in high-risk patients with hematological malignancies colonized by KPC-K.pneumoniae.
Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Clinical outcomes of antimicrobial resistance in cancer patients: a systematic review of multivariable models.BMC infectious diseases · 2023Pooled it
- Assessing Clinical Effectiveness of Ceftolozane/Tazobactam, Ceftazidime/Avibactam, and Meropenem/Vaborbactam in Bacteremia: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Managing multidrug resistant Gram-negative bacteraemia in immunocompromised hosts.Current opinion in infectious diseases · 2026Review
- Clinical Impact of OXA-48-Producing Enterobacterales Rectal Colonization on Hematologic Patients With Febrile Neutropenia.Open forum infectious diseases · 2026Article
- Observational
- Benefits and Safety of Empiric Antibiotic Treatment Active Against KPC-ProducingAntibiotics (Basel, Switzerland) · 2024Article
- Structural and functional diversity of Resistance-Nodulation-Division (RND) efflux pump transporters with implications for antimicrobial resistance.Microbiology and molecular biology reviews : MMBR · 2024Review
- Structural analysis of resistance-nodulation cell division transporters.Microbiology and molecular biology reviews : MMBR · 2024Review
- The antibiotic de-escalation strategy in patients with multidrug-resistant bacterial colonization after allogeneic stem cell transplantation.Frontiers in microbiology · 2024Article
- Article
- Clinical Predictors of Bacteremia Outcome After Initial Empirical Antimicrobial Therapy in Patients with Hematological Malignancies: A Retrospective Analysis.Infection and drug resistance · 2024Article
- Article
- New Bacteriophages Members of thePHAGE (New Rochelle, N.Y.) · 2023Article
- Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms.Microorganisms · 2023Review
- Personalized infection prevention and control: a concept whose time has arrived.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Benefits and Safety of Empiric Antibiotic Treatment Active Against KPC-Infection and drug resistance · 2023Article
- Risk Factors for Mortality and Outcomes in Hematological Malignancy Patients with Carbapenem-ResistantInfection and drug resistance · 2022Article
- Bloodstream Infections in Patients with Rectal Colonization by Carbapenem-Resistant Enterobacteriaceae: A Prospective Cohort Study.Infection and drug resistance · 2022Article
- Reduced transmission ofJAC-antimicrobial resistance · 2021Article
- Place in Therapy of the Newly Available Armamentarium for Multi-Drug-Resistant Gram-Negative Pathogens: Proposal of a Prescription Algorithm.Antibiotics (Basel, Switzerland) · 2021Review
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Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKPC-K.pneumoniae bloodstream infection (KPC-KpBSI) mortality rate in patients with hematological malignancies is reported about 60%. The initial treatment active against KPC-K.pneumoniae is crucial for survival and KPC-K.pneumoniae rectal colonization usually precedes KPC-KpBSI. We evaluated the impact on KPC-KpBSI mortality of the preemptive use of antibiotics active against KPC-K.pneumoniae, as opposed to inactive or standard empiric antibiotics, for the empiric treatment of febrile neutropenia episodes in patients with hematological malignancy identified as KPC-K.pneumoniae intestinal carriers.
methodsWe compared the outcomes of KPC-KpBSIs occurring in high-risk hematological patients known to be colonized with KPC-K.pneumoniae, during two time periods: March2012-December2013 (Period 1, initial approach to KPC-K.pneumoniae spread) and January2017-October2018 (Period 2, full application of the preemptive strategy). The relative importance of the various prognostic factors that could influence death rates were assessed by forward stepwise logistic regression models.
resultsKPC-KpBSI-related mortality in hematological patients identified as KPC-K.pneumoniae carriers dropped from 50% in Period 1 to 6% in Period 2 (p < 0.01), from 58 to 9% in acute myeloid leukemia carriers(p < 0.01). KPC-KpBSIs developed in patients identified as KPC-K.pneumoniae carriers were initially treated with active therapy in 56% and 100% of cases in Period 1 and Period 2, respectively (p < 0.01), in particular with an active antibiotic combination in 39 and 94% of cases, respectively(p < 0.01). The 61% of KPC-KpBSI observed in Period 1 developed during inactive systemic antibiotic treatment (none in Period 2, p < 0.01), fatal in the 73% of cases. Overall, KPC-KpBSI-related mortality was 88% with no initial active treatment, 11.5% with at least one initial active antibiotic (p < 0.01), 9% with initial active combination. Only the initial active treatment resulted independently associated with survival.
conclusionsIn high-risk hematological patients colonized by KPC-K.pneumoniae, the empiric treatment of febrile neutropenia active against KPC-K.pneumoniae reduced KPC-KpBSI-related mortality to 6% and prevented fatal KPC-KpBSI occurrence during inactive systemic antibiotic treatment.
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