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Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project

Infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) are associated with increased mortality in cardiac surgery patients. In this short communication, we report on the changes in the incidence of CR-Kp colonization and CR-Kp infection in cardiac surgery patients from 2014 to 2018 in...

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Autores principales: Giacobbe, Daniele Roberto, Salsano, Antonio, Del Puente, Filippo, Campanini, Francesco, Mariscalco, Giovanni, Marchese, Anna, Viscoli, Claudio, Santini, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783823/
https://www.ncbi.nlm.nih.gov/pubmed/31466372
http://dx.doi.org/10.3390/antibiotics8030132
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author Giacobbe, Daniele Roberto
Salsano, Antonio
Del Puente, Filippo
Campanini, Francesco
Mariscalco, Giovanni
Marchese, Anna
Viscoli, Claudio
Santini, Francesco
author_facet Giacobbe, Daniele Roberto
Salsano, Antonio
Del Puente, Filippo
Campanini, Francesco
Mariscalco, Giovanni
Marchese, Anna
Viscoli, Claudio
Santini, Francesco
author_sort Giacobbe, Daniele Roberto
collection PubMed
description Infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) are associated with increased mortality in cardiac surgery patients. In this short communication, we report on the changes in the incidence of CR-Kp colonization and CR-Kp infection in cardiac surgery patients from 2014 to 2018 in a teaching hospital in Italy, after the implementation of an antimicrobial stewardship project in 2014. During the study period, 2261 patients underwent open-heart surgery. Of them, 130 were found to be colonized by CR-Kp (5.7%) and 52 developed a postoperative CR-Kp infection (2.3%). The crude in-hospital mortality in patients with CR-Kp infections was 48% (25/52). The incidences of both CR-Kp colonization (incidence rate ratio (IRR) 0.82, 95% confidence intervals (CI) 0.78–0.86, p < 0.001) and CR-Kp infection (IRR 0.76, 95% CI 0.69–0.83, p < 0.001) considerably decreased over the study period. This encouraging result should prompt further concerted efforts, directed towards retaining the positive impact of stewardship and infection-control interventions on CR-Kp-related morbidity in the long term.
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spelling pubmed-67838232019-10-16 Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project Giacobbe, Daniele Roberto Salsano, Antonio Del Puente, Filippo Campanini, Francesco Mariscalco, Giovanni Marchese, Anna Viscoli, Claudio Santini, Francesco Antibiotics (Basel) Brief Report Infections due to carbapenem-resistant Klebsiella pneumoniae (CR-Kp) are associated with increased mortality in cardiac surgery patients. In this short communication, we report on the changes in the incidence of CR-Kp colonization and CR-Kp infection in cardiac surgery patients from 2014 to 2018 in a teaching hospital in Italy, after the implementation of an antimicrobial stewardship project in 2014. During the study period, 2261 patients underwent open-heart surgery. Of them, 130 were found to be colonized by CR-Kp (5.7%) and 52 developed a postoperative CR-Kp infection (2.3%). The crude in-hospital mortality in patients with CR-Kp infections was 48% (25/52). The incidences of both CR-Kp colonization (incidence rate ratio (IRR) 0.82, 95% confidence intervals (CI) 0.78–0.86, p < 0.001) and CR-Kp infection (IRR 0.76, 95% CI 0.69–0.83, p < 0.001) considerably decreased over the study period. This encouraging result should prompt further concerted efforts, directed towards retaining the positive impact of stewardship and infection-control interventions on CR-Kp-related morbidity in the long term. MDPI 2019-08-28 /pmc/articles/PMC6783823/ /pubmed/31466372 http://dx.doi.org/10.3390/antibiotics8030132 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Brief Report
Giacobbe, Daniele Roberto
Salsano, Antonio
Del Puente, Filippo
Campanini, Francesco
Mariscalco, Giovanni
Marchese, Anna
Viscoli, Claudio
Santini, Francesco
Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title_full Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title_fullStr Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title_full_unstemmed Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title_short Reduced Incidence of Carbapenem-Resistant Klebsiella pneumoniae Infections in Cardiac Surgery Patients after Implementation of an Antimicrobial Stewardship Project
title_sort reduced incidence of carbapenem-resistant klebsiella pneumoniae infections in cardiac surgery patients after implementation of an antimicrobial stewardship project
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783823/
https://www.ncbi.nlm.nih.gov/pubmed/31466372
http://dx.doi.org/10.3390/antibiotics8030132
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