Efficacy of appropriate antimicrobial therapy on the survival of patients with carbapenem nonsusceptible klebsiella pneumoniae infection

Yi Tsung Lin, Chien Chuang, Chin Fang Su, Yu Jiun Chan, Lih Shinn Wang, Ching Tai Huang, Yin Ching Chuang, L. Kristopher Siu, Chang Phone Fung

研究成果: 雜誌貢獻文章同行評審

9 引文 斯高帕斯(Scopus)

摘要

The impact of antimicrobial treatment on the outcome of carbapenem nonsusceptible Klebsiella pneumoniae (CnsKP) infections needs to be elucidated. This nationwide, multicenter study was conducted to evaluate the impact of appropriate antimicrobial therapy on 14-day mortality among patients with CnsKP infection in Taiwan. Patients with CnsKP infections from 11 medical centers and 4 regional hospitals in Taiwan were enrolled in 2013. Carbapenem nonsusceptibility was defined as a minimum inhibitory concentration of ≥2mg/L for imipenem or meropenem. Predictors of 14-day mortality were determined using the Cox proportional regression model. The influence of infection severity on the impact of appropriate use of antimicrobials on 14-day mortality was determined using the Acute Physiology and Chronic Health Evaluation (APACHE) II score. Overall 14-day mortality was 31.8% (49/154). Unadjusted mortality for appropriate antimicrobial therapy was 23.1% (18/78 patients). Appropriate therapy was independently associated with reduced mortality (hazard ratio [HR], 0.44; 95% confidence interval [CI], 0.24-0.80; P=0.007). A subgroup analysis revealed that the benefit of appropriate therapy was limited to patients with higher APACHE II scores (HR for patients with scores >15 and ≤35, 0.46; 95% CI 0.23-0.92; and for those with scores >35, 0.14; 95% CI, 0.02-0.99). In conclusion, appropriate antimicrobial therapy significantly reduces 14-day mortality for CnsKP infections. Survival benefit is more notable among more severely ill patients.

原文英語
頁(從 - 到)e1405
期刊Medicine (United States)
94
發行號33
DOIs
出版狀態已發佈 - 8月 1 2015
對外發佈

ASJC Scopus subject areas

  • 醫藥 (全部)

指紋

深入研究「Efficacy of appropriate antimicrobial therapy on the survival of patients with carbapenem nonsusceptible klebsiella pneumoniae infection」主題。共同形成了獨特的指紋。

引用此