Evidence map›Paper›PMID 38995342›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2024

Multicenter study on clinical outcomes and poor prognostic factors in patients with Klebsiella pneumoniae bacteremia receiving cefoperazone/sulbactam treatment.

Tsung-Ta Chiang, Ming-Hsien Chiang, Hung-Jen Tang, Zhi-Yuan Shi, Mao-Wang Ho, Chia-Hui Chou, Shang-Yi Lin, Po-Liang Lu, Ting-Shu Wu, Shian-Sen Shie and 5 more

Abstract readMulticenter Study
In one paragraph

Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Tsung-Ta ChiangDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri- Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Taipei, 11490, Taiwan.
Ming-Hsien ChiangDepartment of Nutritional Sciences, Fu-Jen Catholic University, New Taipei City, Taiwan.
Hung-Jen TangDepartment of Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Zhi-Yuan ShiDepartment of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Mao-Wang HoDivision of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Chia-Hui ChouDivision of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Shang-Yi LinDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Po-Liang LuDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Ting-Shu WuDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Shian-Sen ShieDivision of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Jien-Wei LiuDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Feng-Yee ChangDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri- Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Taipei, 11490, Taiwan.
Yin-Ching ChuangDepartment of Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Fu-Der WangDivision of Infectious Diseases, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan. fdwang@vghtpe.gov.tw.
Ya-Sung YangDivision of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri- Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Taipei, 11490, Taiwan. ysyoung4097@gmail.com.

Funding

National Defense Medical Center MND-MAB-D-112115, MND-MAB-D-113078, CMNDMC11206 and CMNDMC11303National Science and Technology Council NSTC 112-2314-B-016-023 and 112-2314-B-016-039Tri-Service General Hospital TSGH-E-112253Tri-Service General Hospital TSGH-E-112286
6 · The paper itself

Abstract

backgroundInfections caused by Klebsiella pneumoniae are common and result in high mortality rates. In vitro studies demonstrated the potency of cefoperazone/sulbactam (CPZ/SUL) against Klebsiella pneumoniae. However, the clinical efficacy of CPZ/SUL for the treatment of K. pneumoniae bacteremia has not been studied.

objectivesThis study aimed to associate the clinical outcomes of patients with bacteremia with the minimal inhibitory concentrations (MICs) of CPZ/SUL against the causative K. pneumoniae isolates.

methodsThis multicenter, retrospective study was conducted in Taiwan between July 2017 and April 2021. Patients with K. pneumoniae bacteremia treated with CPZ/SUL were enrolled in this study. CPZ/SUL MICs were determined using the agar dilution method. Data on the patients' clinical outcomes and characteristics were collected and analyzed.

resultsIn total, 201 patients were enrolled. Among the causative K. pneumoniae isolates, 180 (89.5%) were susceptible to CPZ/SUL. Most patients (n = 156, 77.6%) had favorable outcomes. The 30-day mortality rate was 11.9% (n = 24). Multivariate risk analyses showed that higher APACHE II score (Odds Ratio [OR], 1.14; Confidence Interval [CI], 1.07-1.21; p < 0.001), metastatic tumors (OR, 5.76; CI, 2.31-14.40; p < 0.001), and causative K. pneumoniae CPZ/SUL MICs > 16 µg/ml (OR, 4.30; CI, 1.50-12.27; p = 0.006) were independently associated with unfavorable outcomes.

conclusionPatients with K. pneumoniae bacteremia treated with CPZ/SUL at a ratio 1:1 had favorable outcomes when the CPZ/SUL MICs were ≤ 16 µg/ml. Patients with higher APACHE II scores and metastatic tumors had unfavorable outcomes.

Indexed as

Anti-Bacterial AgentsBacteremiaCefoperazoneKlebsiella InfectionsKlebsiella pneumoniaeMicrobial Sensitivity TestsSulbactamAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesAnti-Bacterial AgentsCefoperazoneSulbactamBacteremiaBreakpointCefoperazoneKlebsiella pneumoniaeMinimal inhibitory concentrationOutcomeSulbactam

Identifiers

PMID38995342
PMCPMC11349846

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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.