Evidence map›Paper›PMID 40835109›Full record

ArticleBiomedical journal2026

Clinical and genomic insights into persistent carbapenem-resistant Klebsiella pneumoniae bacteremia: risk factors, resistance mechanisms, and treatment challenges.

Shian-Sen Shie, Ya-Han Yang, Yin-Hsiang Kung, Chih-Jung Chen

Abstract read
In one paragraph

Article in Biomedical journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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  3. The Odyssey of macrophages.Biomedical journal · 2026
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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

4 authors.

Shian-Sen ShieSchool of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Ya-Han YangSchool of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Yin-Hsiang KungDivision of Pediatric Infectious Diseases, Departments of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chih-Jung ChenSchool of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Pediatric Infectious Diseases, Departments of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Molecular Infectious Diseases Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan. Electronic address: chinjung@cgmh.org.tw.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCarbapenem-resistant Klebsiella pneumoniae (CRKP) is a major cause of nosocomial infections with high mortality rates. Persistent bacteremia, indicative of treatment failure, poses significant clinical challenges. This study aimed to identify clinical parameters for persistent CRKP bacteremia while exploring microbial and genetic characteristics. MATERIALS AND

methodsA case-control study was conducted on patients with CRKP bacteremia from January 2016 to July 2019 at a tertiary hospital in Taiwan. Clinical, demographic, and microbiological data were collected for 61 cases of persistent bacteremia and 122 matched controls without persistent infections. Conditional logistic regression was used to evaluate risk factors for persistent bacteremia. Whole-genome sequencing (WGS) was used to identify genotypes and factors mediating resistance and virulence in the strains.

resultsPersistent CRKP bacteremia was independently associated with mechanical ventilation (adjusted odds ratio [aOR] 11.007, 95 % confidence interval [CI] 2.137-56.693), a lower Pitt bacteremia score (aOR 0.642, 95 % CI 0.494-0.835), and the use of colistin (aOR 11.18, 95 % CI 2.988-41.787) and tigecycline (aOR 16.42, 95 % 4.495-60.0) in definitive therapy. Strains from either group shared similar capsular types. WGS identified three dominant multidrug-resistant clones, ST11, ST307, and ST15, harboring carbapenemase and virulence factors encoding yersiniabactin. A strain of hypervirulent clone ST23 exhibited high virulence but lacked carbapenemase genes, suggesting alternative resistance mechanisms of CR phenotype.

conclusionsAntimicrobial regimens with tigecycline and colistin were insufficient for effectively managing CRKP bacteremia. The convergence of resistance and virulence in prevalent clones demands the urgent introduction of novel therapeutics. Aggressive and tailored strategies are critical for improving outcomes in high-risk patients.

Indexed as

BacteremiaCarbapenem-Resistant EnterobacteriaceaeDrug Resistance, Multiple, BacterialKlebsiella InfectionsKlebsiella pneumoniaeAgedAnti-Bacterial AgentsCase-Control StudiesColistinFemaleHumansLogistic ModelsMaleMicrobial Sensitivity TestsMiddle AgedPrevalenceAnti-Bacterial AgentsColistinTigecyclineBloodstream infectionsCarbapenem-resistant K. pneumoniaeRisk factorsTreatment failureWhole genome sequence

Identifiers

PMID40835109
PMCPMC13084940

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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.