Carbapenemase-producing Enterobacterales constitute a serious public health threat; however, information on the oxacilinasa (OXA-48)-type is limited. The objective of the study was to evaluate the risk factors associated with 14-day mortality for patients with bacteremia due to OXA-48 carbapenemase-producing
Klebsiella pneumoniae
.
We conducted a retrospective, single-center observational study of adult patients with
K. pneumoniae
bacteremia, classifying the strains as carbapenem-susceptible
K. pneumoniae
(CSKp) and carbapenem-resistant
K. pneumoniae
(CRKp). All of the CRKp strains were the OXA-48-type.
The study included 202 cases of bacteremia: 114 due to CSKp and 88 due to CRKp. The clinical cure rate was higher for the patients with CSKp (85% vs 69% for CSKp and CRKp, respectively;
P
= .010), while the 14-day mortality rate was lower (13% vs 30%,
P
= .005). An INCREMENT-CPE score ≥7 (HR 3.05, 95% CI 1.50–6.25,
P
= .002) was the only independent factor associated with 14-day mortality for the patients with
Klebsiella
spp. bacteremia. Other factors related to 14-day mortality were a rapidly fatal prognosis (McCabe) (HR 7.1, 95% CI 2.75–18.37,
P
< .001), dementia (HR 5.9, 95% CI 2.0–7.43,
P
= .001), and a high-risk source of infection (HR 2.7, 95% CI 1.06–6.82,
P
= .038).
The most important factors associated with 14-day mortality for the patients with
K. pneumoniae
bacteremia was an INCREMENT-CPE score ≥7, dementia, a McCabe score indicating a rapidly fatal prognosis and a high-risk source of infection. We found no relationship between a poorer outcome and CRKp isolation or inadequate antibiotic therapy.
PURPOSE: Regular physical activity is associated with fewer exacerbations, hospitalizations and improved survival in patients with COPD. However, patients encounter a number of barriers to starting and sustaining a regular exercise program. The purpose of this abstract is to describe patients' barriers as they commence a physical activity program as part of a large clinical trial.
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