Cargando…

Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections

BACKGROUND: For abdominal solid organ transplant (ASOT) recipients, infection with Klebsiella pneumoniae, particularly carbapenem-resistant K. pneumoniae (CRKP), can be life-threatening. The aims of this study were to characterize the risk factors associated with acquisition of CRKP and 90-day crude...

Descripción completa

Detalles Bibliográficos
Autores principales: Wu, Di, Chen, Chunmei, Liu, Taohua, Wan, Qiquan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458125/
https://www.ncbi.nlm.nih.gov/pubmed/32807765
http://dx.doi.org/10.12659/MSM.922996
_version_ 1783576131658579968
author Wu, Di
Chen, Chunmei
Liu, Taohua
Wan, Qiquan
author_facet Wu, Di
Chen, Chunmei
Liu, Taohua
Wan, Qiquan
author_sort Wu, Di
collection PubMed
description BACKGROUND: For abdominal solid organ transplant (ASOT) recipients, infection with Klebsiella pneumoniae, particularly carbapenem-resistant K. pneumoniae (CRKP), can be life-threatening. The aims of this study were to characterize the risk factors associated with acquisition of CRKP and 90-day crude mortality among patients. MATERIAL/METHODS: In our cohort study, we retrospectively reviewed 68 K. pneumoniae-infected transplant recipients, studied their demographics, clinical manifestations, microbiology, and outcomes, and determined the risk factors associated with the occurrence of CRKP and crude mortality due to K. pneumoniae infections. RESULTS: Sixty-eight ASOT recipients (5.4%) experienced 78 episodes of K. pneumoniae infection. Among these, 20 patients (29.4%) died. The independent risk factors associated with mortality were multiple infected organs or sites (odds ratio=22.034, 95% confidence intervals=4.348–111.653, P=0.001) and septic shock (odds ratio=27.090, 95% confidence intervals=1.841–398.512, P=0.016). Risk factors associated with acquisition of CRKP were multiple infected organs or sites (odds ratio=3.056, 95% confidence intervals=1.091–8.556, P=0.033). CONCLUSIONS: K. pneumoniae infections, especially CRKP, frequently occurred among ASOT recipients, with a high mortality rate. Multiple infected organs or sites and septic shock were predictors of crude mortality caused by K. pneumoniae infections, while CRKP infections were associated with multiple infected organs or sites. Greater efforts are needed towards improved antibiotic administration, early diagnosis and precise treatment, recognition of septic shock, and reduced length of hospitalization.
format Online
Article
Text
id pubmed-7458125
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher International Scientific Literature, Inc.
record_format MEDLINE/PubMed
spelling pubmed-74581252020-09-10 Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections Wu, Di Chen, Chunmei Liu, Taohua Wan, Qiquan Med Sci Monit Clinical Research BACKGROUND: For abdominal solid organ transplant (ASOT) recipients, infection with Klebsiella pneumoniae, particularly carbapenem-resistant K. pneumoniae (CRKP), can be life-threatening. The aims of this study were to characterize the risk factors associated with acquisition of CRKP and 90-day crude mortality among patients. MATERIAL/METHODS: In our cohort study, we retrospectively reviewed 68 K. pneumoniae-infected transplant recipients, studied their demographics, clinical manifestations, microbiology, and outcomes, and determined the risk factors associated with the occurrence of CRKP and crude mortality due to K. pneumoniae infections. RESULTS: Sixty-eight ASOT recipients (5.4%) experienced 78 episodes of K. pneumoniae infection. Among these, 20 patients (29.4%) died. The independent risk factors associated with mortality were multiple infected organs or sites (odds ratio=22.034, 95% confidence intervals=4.348–111.653, P=0.001) and septic shock (odds ratio=27.090, 95% confidence intervals=1.841–398.512, P=0.016). Risk factors associated with acquisition of CRKP were multiple infected organs or sites (odds ratio=3.056, 95% confidence intervals=1.091–8.556, P=0.033). CONCLUSIONS: K. pneumoniae infections, especially CRKP, frequently occurred among ASOT recipients, with a high mortality rate. Multiple infected organs or sites and septic shock were predictors of crude mortality caused by K. pneumoniae infections, while CRKP infections were associated with multiple infected organs or sites. Greater efforts are needed towards improved antibiotic administration, early diagnosis and precise treatment, recognition of septic shock, and reduced length of hospitalization. International Scientific Literature, Inc. 2020-08-18 /pmc/articles/PMC7458125/ /pubmed/32807765 http://dx.doi.org/10.12659/MSM.922996 Text en © Med Sci Monit, 2020 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Wu, Di
Chen, Chunmei
Liu, Taohua
Wan, Qiquan
Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title_full Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title_fullStr Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title_full_unstemmed Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title_short Risk Factors for Acquisition of Carbapenem-Resistant Klebsiella pneumoniae and Mortality Among Abdominal Solid Organ Transplant Recipients with K. pneumoniae Infections
title_sort risk factors for acquisition of carbapenem-resistant klebsiella pneumoniae and mortality among abdominal solid organ transplant recipients with k. pneumoniae infections
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458125/
https://www.ncbi.nlm.nih.gov/pubmed/32807765
http://dx.doi.org/10.12659/MSM.922996
work_keys_str_mv AT wudi riskfactorsforacquisitionofcarbapenemresistantklebsiellapneumoniaeandmortalityamongabdominalsolidorgantransplantrecipientswithkpneumoniaeinfections
AT chenchunmei riskfactorsforacquisitionofcarbapenemresistantklebsiellapneumoniaeandmortalityamongabdominalsolidorgantransplantrecipientswithkpneumoniaeinfections
AT liutaohua riskfactorsforacquisitionofcarbapenemresistantklebsiellapneumoniaeandmortalityamongabdominalsolidorgantransplantrecipientswithkpneumoniaeinfections
AT wanqiquan riskfactorsforacquisitionofcarbapenemresistantklebsiellapneumoniaeandmortalityamongabdominalsolidorgantransplantrecipientswithkpneumoniaeinfections