Your browser doesn't support javascript.
loading
Production of OXA-48 carbapenemase acts as an independent risk factor for poor outcome in Klebsiella pneumoniae infection.
Corbella, Laura; Fernández-Ruiz, Mario; Ruiz-Ruigómez, María; Rodríguez-Goncer, Isabel; Silva, José Tiago; Hernández-Jiménez, Pilar; López-Medrano, Francisco; Lizasoain, Manuel; Villa, Jennifer; Aguado, José María; San-Juan, Rafael.
Afiliación
  • Corbella L; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain. laura_corbella@hotmail.com.
  • Fernández-Ruiz M; Department of Medicine, Universidad Complutense, Madrid, Spain. laura_corbella@hotmail.com.
  • Ruiz-Ruigómez M; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • Rodríguez-Goncer I; Department of Medicine, Universidad Complutense, Madrid, Spain.
  • Silva JT; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
  • Hernández-Jiménez P; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • López-Medrano F; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • Lizasoain M; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • Villa J; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • Aguado JM; Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Sanitaria Hospital "12 de Octubre" (imas12), Centro de Actividades Ambulatorias, 2ª Planta, Bloque D. Avda. de Córdoba S/N, 28041, Madrid, Spain.
  • San-Juan R; Department of Medicine, Universidad Complutense, Madrid, Spain.
Eur J Clin Microbiol Infect Dis ; 42(12): 1485-1497, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37889370
PURPOSE: To know whether the production of OXA-48 carbapenemase exerts an independent impact on the outcome of Klebsiella pneumoniae infection, once adjusted by clinical syndrome and baseline risk factors. METHODS: We performed a case-cohort study including 117 infectious episodes due to OXA-48-producing K. pneumoniae (OXA-48-Kp) and 117 episodes due to non-OXA-48-producing strains (non-OXA-48-Kp). Both groups were matched (1:1 ratio) by clinical syndrome (source of infection, preceding invasive procedures and indwelling devices, and associated bacteremia) and hospitalization ward at infection onset. Multivariate Cox regression was used to investigate the association between OXA-48-Kp infection and clinical cure by day 14 (primary outcome) and 30-day all-cause mortality (secondary outcome). RESULTS: Both study groups were well balanced regarding underlying conditions and comorbidity burden. Sepsis or septic shock were more frequent in OXA-48-Kp cases than non-OXA-48-Kp controls (41 [35.0%] vs. 17 [14.5%]; P-value < 0.0001). Clinical cure by day 14 was less commonly achieved in OXA-48-Kp cases (49 [41.9%] vs. 95 [81.2%]; P-value < 0.001), whereas 30-day all-cause mortality was higher (33 [28.2%] vs. 18 [15.4%]; P-value = 0.018). Multivariate analysis confirmed that OXA-48-Kp infection was independently associated with the lack of 14-day clinical cure (adjusted hazard ratio [aHR]: 0.45; 95% confidential interval [95%CI]: 0.29-0.70; P-value < 0.0001). A non-significant association was observed for 30-day all-cause mortality (aHR: 1.65; 95%CI: 0.92-2.94; P-value = 0.093). CONCLUSION: Our matched analysis suggests that the production of OXA-48 carbapenemase acts as an independent risk factor for poor outcome in K. pneumoniae infection as compared to episodes due to non-carbapenemase-producing strains.
Asunto(s)
Palabras clave

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infecciones por Klebsiella / Klebsiella pneumoniae Límite: Humans Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: España

Texto completo: 1 Banco de datos: MEDLINE Asunto principal: Infecciones por Klebsiella / Klebsiella pneumoniae Límite: Humans Idioma: En Revista: Eur J Clin Microbiol Infect Dis Asunto de la revista: DOENCAS TRANSMISSIVEIS / MICROBIOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: España