Does antimicrobial therapy affect mortality of patients with carbapenem-resistant Klebsiella pneumoniae bacteriuria? A nationwide multicenter study in Taiwan

Chien Chuang, Chin Fang Su, Jung Chung Lin, Po Liang Lu, Ching Tai Huang, Jann Tay Wang, Yin Ching Chuang, L. Kristopher Siu, Chang Phone Fung, Yi Tsung Lin

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Few clinical studies have previously discussed patients with carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteriuria. This study aimed to assess the effect of antimicrobial therapy on the mortality of patients with CRKP bacteriuria. Hospitalized adults with CRKP bacteriuria were enrolled retrospectively from 16 hospitals in Taiwan during 2013 and 2014. Critically ill patients were defined as those with an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥ 20. Multivariate Cox regression analysis was used to determine independent risk factors for 14-and 28-day mortality. Of 107 patients with CRKP bacteriuria, the 14-day and 28-day mortality was 14.0% and 25.2%, respectively. Thirty-three patients received appropriate antimicrobial therapy. In the multivariate Cox regression analysis, the APACHE II score ≥ 20 was the only independent risk factor for 14-day mortality (hazard ratio [HR]: 6.15, p = 0.024). APACHE II score ≥ 20 (HR: 3.05, p = 0.018) and male sex (HR: 2.57, p = 0.037) were associated with 28-day mortality. Among critically ill patients with CRKP bacteriuria, appropriate antimicrobial therapy was not associated with 14-day or 28-day survival. In conclusion, in patients with CRKP bacteriuria, the use of appropriate antimicrobial therapy was not an independent factor associated with reduced mortality. Our findings may inform future antibiotic stewardship interventions for bacteriuria caused by multidrug resistant pathogens.

Original languageEnglish
Article number2035
Pages (from-to)1-11
Number of pages11
JournalMicroorganisms
Volume8
Issue number12
DOIs
Publication statusPublished - Dec 2020
Externally publishedYes

Keywords

  • Antimicrobial therapy
  • Bacteriuria
  • Carbapenem resistant
  • Critically ill
  • Klebsiella pneumoniae

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Virology

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