External validation of the INCREMENT-CPE mortality score in a carbapenem-resistant Klebsiella pneumoniae bacteraemia cohort: the prognostic significance of colistin resistance

Machuca, Isabel; Gutiérrez‐Gutiérrez, Belén; Rivera-Espinar, Francisco; Cano, Ángela; Gracia-Ahufinger, Irene; Guzmán-Puche, Julia; Marfil-Pérez, Eduardo; Pérez‐Nadales, Elena; Castón, Juan José; Carmeli, Yehuda; Paterson, David L.; Pascual, Álvaro; Martı́nez-Martı́nez, Luis; Torre‐Cisneros, Julián

doi:10.1016/j.ijantimicag.2019.07.017

Cited by 13 publications

(11 citation statements)

References 31 publications

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“…ICS showed a predictive capacity (AUC 0.800) comparable to other specific scores such as the Pitt bacteraemia score (0.799) or general ones such as SAPS II (0.797) and SOFA score (0.815). The predictive capacity was also similar to that from the INCREMENT cohort (0.800) and from others [5e7]; in a cohort of patients treated with ceftazidime/avibactam, the AUC was 0.704, and in another with colistin-resistant CP-Kp isolates the AUC was 0.770 [6,7]. In our cohort, it also showed good performance (0.784) in the subset of episodes due to colistin-resistant isolates.…”

Section: Discussionsupporting

confidence: 88%

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External validation of INCREMENT-CPE score in a retrospective cohort of carbapenemase-producing Klebsiella pneumoniae bloodstream infections in critically ill patients

Papadimitriou-Olivgeris

Bartzavali

Georgakopoulou

et al. 2021

Clinical Microbiology and Infection

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Objectives: Our aim was to validate the INCREMENT-CPE score (ICS) in patients hospitalized in the intensive care unit (ICU) with bacteraemia due to carbapenemase-producing Klebsiella pneumoniae (CP-Kp). Methods: The study was conducted in the ICU of the University General Hospital of Patras, Greece, during a 10-year period (2010e2019). Patients with monomicrobial bacteraemia due to CP-Kp were included. Primary outcome was 14-day mortality. MICs of meropenem, tigecycline, fosfomycin and ceftazidime/ avibactam were determined by Etest, whereas for colistin the broth microdilution method was applied. PCR for bla KPC , bla VIM , bla NDM and bla OXA genes was used. Results: Among 384 CP-Kp bacteraemias, most were primary (166, 43.2%) followed by catheter-related (143, 37.2%). Most isolates carried bla KPC (318, 82.8%). Fourteen-day mortality was 26.3% (101 patients). ICS score was 11.1 ± 4.2. An ICS 10 showed a sensitivity of 98.0% and a negative predictive value of 98.7%. The area under the curve of ICS (0.800) was comparable to those of the Pitt bacteraemia score (0.799), the Simplified Acute Physiology Score II (SAPS II) (0.797) and the Sequential Organ Failure Assessment score (SOFA) (0.815). Conclusions: ICS showed predictive efficacy similar to that of the SAPS II, SOFA and Pitt bacteraemia scores.

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Section: Discussionsupporting

confidence: 88%

“…The ICS was further validated in a cohort of colistin-resistant pathogens [6] and those treated with ceftazidime/avibactam [7]. Since all previous studies included patients hospitalized in different wards, data concerning critically ill patients are lacking [5e7].…”

Section: Introductionmentioning

confidence: 99%

External validation of INCREMENT-CPE score in a retrospective cohort of carbapenemase-producing Klebsiella pneumoniae bloodstream infections in critically ill patients

Papadimitriou-Olivgeris

Bartzavali

Georgakopoulou

et al. 2021

Clinical Microbiology and Infection

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“…Falcone et al showed that colistin resistance and intra-abdominal infection were independent risk factors for death in patients with CRKP septic shock (Falcone et al, 2016). Machuca et al found that septic shock and admission to the ICU are independent risk factors for 30-day death in patients with CRKP, and combined anti-infective therapy can reduce the mortality of septic shock patients with CRKP bacteremia (Machuca et al, 2019). The detection rate of drug-resistant bacteria is increasing day by day, and the 2.9 times higher mortality rate of patients with CRKP infection versus CSKP patients highlights the importance of developing pre-control.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation and Prognostic Analysis of Patients With Klebsiella pneumoniae Bloodstream Infection

Zhang

Yang

Wang

et al. 2020

Front. Cell. Infect. Microbiol.

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“…In 2006 researchers found that the reason for carbapenem resistance of this batch of CRKP was the presence of the bla VIM−1 gene (28,29). In 2008, a number of studies found the bla KPC−2 gene present in CRKP isolates and, at one time, there was an epidemic in two separate hospitals (30,31 (38). The detection rate of drug-resistant bacteria is increasing day by day, and the 2.9 times higher mortality rate of patients with CRKP infection versus CSKP patients highlights the importance of developing pre-control.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation and prognostic analysis of patients with Klebsiella pneumoniae bloodstream infection

Sun

Zhang

Yang

et al. 2020

Preprint

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Background and Purpose: The clinical prognosis of Klebsiella pneumoniae bloodstream infection is poor, and the prevalence of drug-resistant bacteria makes clinical anti-infective treatment more challenging. This retrospective study evaluated the epidemiological characteristics of patients with Klebsiella pneumoniae, the risk factors for drug-resistant bacterial infection and death, and analyzed treatment options. Methods: Clinical data of 297 patients diagnosed with Klebsiella pneumoniae bacteremia between June 2014 and June 2019 were collected.Results: Intensive care unit hospitalization history, operation history, recent antibiotic use history, mechanical ventilation, and number of days hospitalized before bloodstream infection were found to be independent risk factors for drug-resistant bacterial infection. The risk of death for carbapenem-resistant Klebsiella pneumoniae infection was 2.942 times higher than that for carbapenem-sensitive Klebsiella pneumoniae infection. For extensively drug-resistant Klebsiella pneumoniae bacteremia patients, the mortality rate of combined anti-infective therapy was lower.Conclusions: Clinicians should pay attention to patients with high-risk drug-resistant bacteria infection and administer timely anti-infection treatment. The findings of this study may provide some suggestions for early identification and standardized treatment of patients with Klebsiella pneumoniae bacteremia.

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External validation of the INCREMENT-CPE mortality score in a carbapenem-resistant Klebsiella pneumoniae bacteraemia cohort: the prognostic significance of colistin resistance

Cited by 13 publications

References 31 publications

External validation of INCREMENT-CPE score in a retrospective cohort of carbapenemase-producing Klebsiella pneumoniae bloodstream infections in critically ill patients

External validation of INCREMENT-CPE score in a retrospective cohort of carbapenemase-producing Klebsiella pneumoniae bloodstream infections in critically ill patients

Clinical Observation and Prognostic Analysis of Patients With Klebsiella pneumoniae Bloodstream Infection

Clinical observation and prognostic analysis of patients with Klebsiella pneumoniae bloodstream infection

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