Clinical outcomes of patients hospitalized in internal medicine wards adequately treated for bloodstream infections caused by NDM-producing Klebsiella pneumoniae. Results from a real-life retrospective multi-center study in an endemic area.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-03-07 DOI:10.1007/s15010-025-02488-x

Simone Meini, Roberta Del Cesta, Francesco Sbrana, Javier Rosada, Davide Carrara, Maddalena Mura, Benedetta Longo, Roberto Andreini, Giuseppe Linsalata, Alessandro Fedele, Francesco Filidei, Andrea Ripoli, Elisabetta Andreoli, Enrico Tagliaferri, Spartaco Sani

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引用次数: 0

Abstract

Background: New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae (NDM-Kp) represents a growing challenge for modern medicine.

Objectives: To assess real-life clinical outcomes in patients adequately treated in Internal medicine units (IMUs) for bloodstream infections (BSI) caused by NDM-Kp.

Methods: A two-years retrospective study was conducted recruiting 30 consecutive adult patients with NDM-Kp BSI treated with an adequate definitive antibiotic therapy (27 aztreonam plus ceftazidime/avibactam; 3 cefiderocol) in three Italian IMUs located in a highly endemic area.

Results: Mean age of patients was 75.3 years, mean Charlson Comorbidity Index (CCI) 7.5. All the patients had rectal colonization. Thirty-day mortality rate was 46.7%; 78.6% of patients who died received an adequate empiric therapy. Non-survivors had mean age, CCI and SOFA score significantly higher compared to survivors (80.1 vs. 71.2, p = 0.036; 8.6 vs. 6.6, p = 0.047; 5.9 vs. 4, p = 0.043, respectively). The percentage of survivors was significantly higher among the 13 cases with community-acquired than in the 17 with hospital-acquired BSI (76.9% vs. 35.3%, p = 0.024). In the multivariate penalized logistic regression analysis, age, CCI, SOFA score and hospital-acquired BSI onset were identified as independent predictors of mortality.

Conclusion: This study provides real-life data on clinical outcomes regarding old and highly multimorbid patients hospitalized in IMU for BSI caused by NDM-Kp, showing a very high 30-day mortality even in case of adequate treatment.

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.