Evidence map›Paper›PMID 40295934›Full record

Observational studyBMC infectious diseases2025

Management practices and mortality predictors among Klebsiella pneumoniae infections across Lebanese hospitals: a multicenter retrospective study.

Rania Itani, Hani M J Khojah, Hamza Raychouni, Rahaf Kibrit, Patricia Shuhaiber, Carole Dib, Mariam Hassan, Tareq L Mukattash, Abdalla El-Lakany

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Biofilm-Forming Capacity andAntibiotics (Basel, Switzerland) · 2026
    Article
  3. Article
  4. Clinical risk factors and genomic characterization of carbapenem-resistantFrontiers in cellular and infection microbiology · 2026
    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

9 authors.

Rania ItaniPharmacy Practice Department, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon. r.itani@bau.edu.lb.
Hani M J KhojahDepartment of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia.
Hamza RaychouniIntensive Care Unit, Anesthesia Department, Central Military Hospital, Military Healthcare, Lebanese Army, Beirut, Lebanon.
Rahaf KibritPharmacy Department, Lebanese Hospital Geitaoui University Medical Center, Beirut, Lebanon.
Patricia ShuhaiberPharmacy Department, Mount Lebanon Hospital Balamand University Medical Center, Hazmieh, Lebanon.
Carole DibPharmacy Department, Lebanese Hospital Geitaoui University Medical Center, Beirut, Lebanon.
Mariam HassanEmergency Department, Sahel General Hospital, Beirut, Lebanon.
Tareq L MukattashDepartment of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Abdalla El-LakanyDepartment of Pharmaceutical Sciences, Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKlebsiella pneumoniae is a significant cause of both community-acquired and nosocomial infections, leading to high morbidity and mortality rates. The increasing antimicrobial resistance among K. pneumoniae strains poses a critical challenge to effective treatment. This study aimed to assess the appropriateness of initial antimicrobial therapy, determine the 30-day all-cause mortality rate, and identify predictors of mortality among patients infected with K. pneumoniae in Lebanese hospitals.

methodsA multicenter retrospective observational study was conducted across three university hospitals in Beirut, Lebanon. The study included hospitalized adult patients with confirmed K. pneumoniae infections. Kaplan-Meier survival analysis and log-rank tests were used to analyze time-to-mortality. Binary logistic regression was performed to identify predictors of mortality.

resultsOf 2,655 cases screened, 410 patients were enrolled, and 395 cases were included in the final analysis of the 30-day mortality after excluding those lost to follow-up. Nearly one-third of the isolates (36.8%) were extended-spectrum β-lactamase (ESBL)-producing, while 6.8% were carbapenem-resistant K. pneumoniae (CRKP). The most commonly prescribed empirical antibiotics were meropenem (31.7%), amikacin (28.5%), and ceftriaxone (22.2%). Around one-third of the patients (32.9%) received inappropriate initial antimicrobial therapy. The 30-day mortality rate was 14.4%. Main predictors significantly associated with mortality in patients with K. pneumoniae infection were solid cancer (adjusted odds ratio [AOR] = 7.82, P < 0.01), coronary artery disease (AOR = 4.81, P = 0.01), age ≥ 65 years (AOR = 4.22, P = 0.02), type II diabetes mellitus (AOR = 3.96, P = 0.01), receiving inappropriate initial antimicrobial therapy (AOR = 2.96, P = 0.02), infection with CRKP isolates (AOR = 2.53, P = 0.03), and having a higher Charlson comorbidity index (AOR = 1.61, P = 0.001).

conclusionsThe study highlights the critical need for effective antimicrobial stewardship and tailored infection control protocols to mitigate the high resistance rates and improve patient outcomes in Lebanon. Emphasis should be placed on enhancing the monitoring of local resistance patterns and using these data to guide the selection of appropriate empirical therapy to reduce mortality associated with K. pneumoniae infections.

Indexed as

Anti-Bacterial AgentsKlebsiella InfectionsKlebsiella pneumoniaeAdultAgedAged, 80 and overCross InfectionFemaleHospitalsHumansLebanonMaleMiddle AgedRetrospective StudiesAnti-Bacterial AgentsAntibiogramAntibioticsAntimicrobial drug resistanceAntimicrobial therapyCarbapenem-resistantESBL-producingKlebsiella pneumoniaeLebanonMortality predictorsNosocomial infections

Identifiers

PMID40295934
PMCPMC12039178

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.