Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Impact of a Rapid Molecular Test for Klebsiella pneumoniae Carbapenemase and Ceftazidime-Avibactam Use on Outcomes After Bacteremia Caused by Carbapenem-Resistant Enterobacterales.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Pooled it
- Pooled it
- A rapid, inexpensive diagnostic for bacterial pathogen and resistance detection in resource-limited settings.Science advances · 2026Article
- Assessing Clinical Effectiveness of Ceftolozane/Tazobactam, Ceftazidime/Avibactam, and Meropenem/Vaborbactam in Bacteremia: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- OmpK36 GD insertion induces RpoS-dependentAntimicrobial agents and chemotherapy · 2026Article
- [Advances in integrated antimicrobial resistance diagnostics: quantitative, qualitative and AI-driven approaches].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Review
- Article
- Clinical effect of in-house rapid diagnostic process on patients with bloodstream infections due to carbapenem-resistant bacteria or methicillin-resistantMicrobiology spectrum · 2026Article
- The changing epidemiology and long-term outcomes of patients with CRE infections.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Rapid and high-sensitivity quantitative fluorescent immunoassay for detection ofFrontiers in microbiology · 2026Article
- Current progress in antibacterial agents for carbapenem-resistant enterobacterales.Frontiers in pharmacology · 2026Review
- Limits of rapid diagnostics: genomic and structural insights into OXA-48-like mediated carbapenem resistance inFrontiers in microbiology · 2026Article
- Predictors of 30-day mortality in critically ill patients with bloodstream infections caused by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae: a five-year retrospective study.BMC infectious diseases · 2025Article
- Article
- Cefepime failure for the treatment of cefepime-susceptible, KPC-producingASM case reports · 2025Article
- Antibiotic therapy for severe bacterial infections.Intensive care medicine · 2025Review
- Optimizing Clinical Indicators in Hematologic Malignancies and Sepsis Using ddPCR: A Retrospective Study.Infectious diseases and therapy · 2025Article
- Beyond Accuracy: Methodological Advances for Assessing the Clinical Impact of Infectious Disease Diagnostics.Open forum infectious diseases · 2025Article
- Nosocomial transmission, adaption and clinical outcomes of carbapenem-resistant hypervirulent Klebsiella pneumoniae.BMC microbiology · 2025Article
- The importance of monitoring a new antibiotic: ceftazidime/avibactam usage and resistance experience from England, 2016 to 2020.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
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22 authors at 14 institutions in 1 country.
Funding
Abstract
backgroundPatients with bacteremia due to carbapenem-resistant Enterobacterales (CRE) experience delays until appropriate therapy and high mortality rates. Rapid molecular diagnostics for carbapenemases and new β-lactam/β-lactamase inhibitors may improve outcomes.
methodsWe conducted an observational study of patients with CRE bacteremia from 2016 to 2018 at 8 New York and New Jersey medical centers and assessed center-specific clinical microbiology practices. We compared time to receipt of active antimicrobial therapy and mortality between patients whose positive blood cultures underwent rapid molecular testing for the Klebsiella pneumoniae carbapenemase (KPC) gene (blaKPC) and patients whose cultures did not undergo this test. CRE isolates underwent antimicrobial susceptibility testing by broth microdilution and carbapenemase profiling by whole-genome sequencing. We also assessed outcomes when ceftazidime-avibactam and polymyxins were used as targeted therapies.
resultsOf 137 patients with CRE bacteremia, 89 (65%) had a KPC-producing organism. Patients whose blood cultures underwent blaKPC PCR testing (n = 51) had shorter time until receipt of active therapy (median: 24 vs 50 hours; P = .009) compared with other patients (n = 86) and decreased 14-day (16% vs 37%; P = .007) and 30-day (24% vs 47%; P = .007) mortality. blaKPC PCR testing was associated with decreased 30-day mortality (adjusted odds ratio: .37; 95% CI: .16-.84) in an adjusted model. The 30-day mortality rate was 10% with ceftazidime-avibactam monotherapy and 31% with polymyxin monotherapy (P = .08).
conclusionsIn a KPC-endemic area, blaKPC PCR testing of positive blood cultures was associated with decreased time until appropriate therapy and decreased mortality for CRE bacteremia, and ceftazidime-avibactam is a reasonable first-line therapy for these infections.
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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.