Evidence map›Paper›PMID 39643843›Full record

Observational studyInfection2025

Bacteremic nosocomial pneumonia caused by Gram-negative bacilli: results from the nationwide ALARICO study in Italy.

Giusy Tiseo, Valentina Galfo, Sergio Carbonara, Andrea Marino, Giovanni Di Caprio, Anna Carretta, Alessandra Mularoni, Michele Fabiano Mariani, Alberto Enrico Maraolo, Riccardo Scotto and 28 more

Erratum issuedAbstract readObservational StudyMulticenter Study
PubMed Publisher
In one paragraph

Observational study in Infection, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–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

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. [Multidrug resistance and new anti-infective agents].Innere Medizin (Heidelberg, Germany) · 2026
    Review
  3. Article
  4. Review
  5. Challenges and opportunities in the management of severe pneumonia. Key concepts from the Seventh Annual Meeting of Spanish Experts 2025.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026
    Review
  6. Article
  7. Observational
  8. Article
  9. Effectiveness and safety of cefiderocol treatment in patients with Gram-negative bacterial infections in Spain in the early access programme: results of the PERSEUS study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025
    Article
  10. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

38 authors.

Giusy TiseoInfectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
Valentina GalfoInfectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy.
Sergio CarbonaraInfectious Disease Unit, ASL BT, Bisceglie, Italy.
Andrea MarinoUnit of InfectiousDiseases, ARNAS Garibaldi, Department of Clinical and Experimental Medicine, Nesima Hospital, University of Catania, Catania, Italy.
Giovanni Di CaprioInfectious Diseases Unit, AORN Sant' Anna e San Sebastiano, Caserta, Italy.
Anna CarrettaInfectious Diseases Unit, Department of Clinical and Surgical Sciences, University of Foggia, AOU Policlinico Riuniti Foggia, Foggia, Italy.
Alessandra MularoniDepartment of Infectious Diseases, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), Palermo, Italy.
Michele Fabiano MarianiDepartment of Biomedical Sciences and Human Oncology, Clinic of Infectious Diseases, University of Bari "Aldo Moro", Bari, Italy.
Alberto Enrico MaraoloFirstDivision of Infectious Diseases, Cotugno Hospital, AORN Ospedali dei Colli, Naples, Italy.
Riccardo ScottoFirstDivision of Infectious Diseases, Cotugno Hospital, AORN Ospedali dei Colli, Naples, Italy.
Lidia DalfinoAnesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy.
Lorenzo CorboMedicina per la complessità assistenziale 1 AOU Careggi, Florence, Italy.
Margherita MaceraDepartment of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Alice Annalisa MedagliaInfectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy.
Maria Luca d'ErricoInfectious Diseases Unit, Department of Clinical and Surgical Sciences, University of Foggia, AOU Policlinico Riuniti Foggia, Foggia, Italy.
Claudia GioèInfectious and Tropical Disease Unit, AOU Policlinico "P. Giaccone", Palermo, Italy.
Christian SgroiAzienda Ospedaliera Garibaldi, Catania, Italy.
Rosa Fontana Del VecchioDepartment of Infectious Diseases, Umberto I Public Hospital, Siracusa, Italy.
Giancarlo CeccarelliDepartment of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
Antonio AlbaneseInfectious Diseases Unit, Ospedale Papardo, Messina, Italy.
Calogero BuscemiInfectious Diseases Unit, ARNAS Ospedale Civico of Palermo, Palermo, Italy.
Simona TalamancaDipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Palermo, Italy.
Giuseppe FotiInfetious Diseases Unit, "Bianchi-Melacrino-Morelli" Hospital, Reggio Calabria, Italy.
Giulio De StefanoDepartment of Infectious Diseases, Hospital of Potenza and Matera, Matera, Italy.
Antonina FrancoDepartment of Infectious Diseases, Umberto I Public Hospital, Siracusa, Italy.
Carmelo IacobelloUOC Malattie Infettive, Azienda Ospedaliera per L'Emergenza, Cannizzaro, Catania, Italy.
Salvatore CorraoDepartment of Clinical Medicine, Internal Medicine Division, ARNAS Civico Di Cristina Benfratelli Hospital Trust, Palermo, Italy.
Domenico MoranaMedicina Interna MIAMA, Ospedale S. Maria della Misericordia, Perugia, Italy.
Filippo PieralliIntermediate Care Unit, Careggi University Hospital, Florence, Italy.
Ivan GentileFirstDivision of Infectious Diseases, Cotugno Hospital, AORN Ospedali dei Colli, Naples, Italy.
Teresa SantantonioInfectious Diseases Unit, Department of Clinical and Surgical Sciences, University of Foggia, AOU Policlinico Riuniti Foggia, Foggia, Italy.
Antonio CascioDepartment of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties G D'Alessandro, University of Palermo, Palermo, Italy.
Nicola CoppolaDepartment of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Bruno CacopardoUnit of InfectiousDiseases, ARNAS Garibaldi, Department of Clinical and Experimental Medicine, Nesima Hospital, University of Catania, Catania, Italy.
Mario VendittiDepartment of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
Francesco MenichettiItalian Group for Antimicrobial Stewardship (GISA), Pisa, Italy.
Marco FalconeInfectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy. marco.falcone@unipi.it.
ALARICO Network

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo describe the clinical characteristics and outcomes of patients with nosocomial pneumonia (NP) caused by carbapenem-resistant Gram-negative bacilli (CR-GNB) and to compare them to patients with NP caused by carbapenem-susceptible (CS)-GNB.

methodsProspective observational multicenter study including patients with bacteremic NP caused by GNB from the ALARICO Network (June 2018-January 2020). The primary outcome measure was 30-day mortality. A Cox regression analysis was performed to identify factors independently associated with 30-day mortality. Hazard ratio (HR) and 95% confidence intervals (CI) were calculated.

resultsOverall, 167 patients with GNB NP were included: 101 with bacteremic NP caused by CR-GNB (n = 39 by KPC-producing Klebsiella pneumoniae, n = 29 by carbapenem-resistant Acinetobacter baumannii, n = 28 by carbapenem-resistant Pseudomonas aeruginosa, n = 5 by MBL-producing Klebsiella pneumoniae) and 66 cases of bacteremic CS-GNB NP. Thirty-day mortality rate was higher in patients with NP caused by CR-GNB compared to those with NPcaused by CS-GNB (46.5% vs 30.3%, p = 0.036). On multivariable analysis, age (HR 1.044, 95% CI 1.021-1.067, p < 0.001), hematological malignancy (HR 4.307, 95% CI 1.924-9.643, p < 0.001) and septic shock (HR 3.668, 95% CI 2.001-6.724, p < 0.001) were factors independently associated with 30-day mortality, while the receipt of adequate antibiotic therapy within 24 h from infection onset (HR 0.495, 95% CI 0.252-0.969, p = 0.04) was a protective factor. Carbapenem resistance was not associated with increased risk of mortality (HR 1.075, 95% CI 0.539-2.142, p = 0.837).

conclusionsPatients with bacteremic NP caused by CR-GNB have high mortality rate. Strategies to reduce the time from infection to the administration of adequate antibiotic therapy should be implemented in patients with NP.

Indexed as

BacteremiaCross InfectionGram-Negative BacteriaGram-Negative Bacterial InfectionsHealthcare-Associated PneumoniaAgedAged, 80 and overAnti-Bacterial AgentsCarbapenemsFemaleHumansItalyKlebsiella pneumoniaeMaleMiddle AgedProspective StudiesAnti-Bacterial AgentsCarbapenemsAcinetobacter baumanniiCarbapenem-resistanceGram-negative bacilliKlebsiella pneumoniaeMultidrug resistancePseudomonas aeruginosa

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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.