Carbapenem-resistant Klebsiella pneumoniae infections in kidney transplant recipients

A case-control study

J. Simkins, V. Muggia, H. W. Cohen, Grace Y. Minamoto

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have emerged as a significant challenge in solid organ transplantation. CRKP infections in other patient populations have been associated with higher mortality, when compared to infections caused by carbapenem-sensitive K. pneumoniae (CSKP). Aims: The aim of this study was to evaluate possible risk factors, clinical characteristics, and outcomes of CRKP infections compared with CSKP infections in kidney transplant recipients (KTR). Methods: We retrospectively investigated 13 CRKP infections and 39 CSKP infections in KTR (2006-2010). Results: CRKP was not significantly associated with age, gender, or comorbidities. CRKP infections were significantly associated with recent exposure to broad-spectrum antibiotics and were more likely to have been managed on an inpatient basis and to have required source control. CRKP was significantly associated with earlier mortality. Six of 13 (46%) patients with CRKP infection, and none of the patients with CSKP infection, died within 6.5 months of infection onset. Although cases and controls did not differ significantly with respect to diabetes, all patients (100%, n = 9) who died during the study had diabetes, while 58% of the 43 survivors had diabetes (P = 0.02). Conclusion: In conclusion, CRKP compared with CSKP is associated with greater risk of mortality. Investigations on ways to better prevent CRKP are urgently needed.

Original languageEnglish (US)
Pages (from-to)775-782
Number of pages8
JournalTransplant Infectious Disease
Volume16
Issue number5
DOIs
StatePublished - Oct 1 2014

Fingerprint

Klebsiella Infections
Carbapenems
Klebsiella pneumoniae
Case-Control Studies
Kidney
Pneumonia
Infection
Transplant Recipients
Mortality

Keywords

  • Carbapenem resistance
  • Kidney transplantation
  • Klebsiella pneumoniae infection

ASJC Scopus subject areas

  • Transplantation
  • Infectious Diseases
  • Medicine(all)

Cite this

Carbapenem-resistant Klebsiella pneumoniae infections in kidney transplant recipients : A case-control study. / Simkins, J.; Muggia, V.; Cohen, H. W.; Minamoto, Grace Y.

In: Transplant Infectious Disease, Vol. 16, No. 5, 01.10.2014, p. 775-782.

Research output: Contribution to journalArticle

@article{3c53889528dd480ea359215365642c0b,
title = "Carbapenem-resistant Klebsiella pneumoniae infections in kidney transplant recipients: A case-control study",
abstract = "Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have emerged as a significant challenge in solid organ transplantation. CRKP infections in other patient populations have been associated with higher mortality, when compared to infections caused by carbapenem-sensitive K. pneumoniae (CSKP). Aims: The aim of this study was to evaluate possible risk factors, clinical characteristics, and outcomes of CRKP infections compared with CSKP infections in kidney transplant recipients (KTR). Methods: We retrospectively investigated 13 CRKP infections and 39 CSKP infections in KTR (2006-2010). Results: CRKP was not significantly associated with age, gender, or comorbidities. CRKP infections were significantly associated with recent exposure to broad-spectrum antibiotics and were more likely to have been managed on an inpatient basis and to have required source control. CRKP was significantly associated with earlier mortality. Six of 13 (46{\%}) patients with CRKP infection, and none of the patients with CSKP infection, died within 6.5 months of infection onset. Although cases and controls did not differ significantly with respect to diabetes, all patients (100{\%}, n = 9) who died during the study had diabetes, while 58{\%} of the 43 survivors had diabetes (P = 0.02). Conclusion: In conclusion, CRKP compared with CSKP is associated with greater risk of mortality. Investigations on ways to better prevent CRKP are urgently needed.",
keywords = "Carbapenem resistance, Kidney transplantation, Klebsiella pneumoniae infection",
author = "J. Simkins and V. Muggia and Cohen, {H. W.} and Minamoto, {Grace Y.}",
year = "2014",
month = "10",
day = "1",
doi = "10.1111/tid.12276",
language = "English (US)",
volume = "16",
pages = "775--782",
journal = "Transplant Infectious Disease",
issn = "1398-2273",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Carbapenem-resistant Klebsiella pneumoniae infections in kidney transplant recipients

T2 - A case-control study

AU - Simkins, J.

AU - Muggia, V.

AU - Cohen, H. W.

AU - Minamoto, Grace Y.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have emerged as a significant challenge in solid organ transplantation. CRKP infections in other patient populations have been associated with higher mortality, when compared to infections caused by carbapenem-sensitive K. pneumoniae (CSKP). Aims: The aim of this study was to evaluate possible risk factors, clinical characteristics, and outcomes of CRKP infections compared with CSKP infections in kidney transplant recipients (KTR). Methods: We retrospectively investigated 13 CRKP infections and 39 CSKP infections in KTR (2006-2010). Results: CRKP was not significantly associated with age, gender, or comorbidities. CRKP infections were significantly associated with recent exposure to broad-spectrum antibiotics and were more likely to have been managed on an inpatient basis and to have required source control. CRKP was significantly associated with earlier mortality. Six of 13 (46%) patients with CRKP infection, and none of the patients with CSKP infection, died within 6.5 months of infection onset. Although cases and controls did not differ significantly with respect to diabetes, all patients (100%, n = 9) who died during the study had diabetes, while 58% of the 43 survivors had diabetes (P = 0.02). Conclusion: In conclusion, CRKP compared with CSKP is associated with greater risk of mortality. Investigations on ways to better prevent CRKP are urgently needed.

AB - Introduction: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections have emerged as a significant challenge in solid organ transplantation. CRKP infections in other patient populations have been associated with higher mortality, when compared to infections caused by carbapenem-sensitive K. pneumoniae (CSKP). Aims: The aim of this study was to evaluate possible risk factors, clinical characteristics, and outcomes of CRKP infections compared with CSKP infections in kidney transplant recipients (KTR). Methods: We retrospectively investigated 13 CRKP infections and 39 CSKP infections in KTR (2006-2010). Results: CRKP was not significantly associated with age, gender, or comorbidities. CRKP infections were significantly associated with recent exposure to broad-spectrum antibiotics and were more likely to have been managed on an inpatient basis and to have required source control. CRKP was significantly associated with earlier mortality. Six of 13 (46%) patients with CRKP infection, and none of the patients with CSKP infection, died within 6.5 months of infection onset. Although cases and controls did not differ significantly with respect to diabetes, all patients (100%, n = 9) who died during the study had diabetes, while 58% of the 43 survivors had diabetes (P = 0.02). Conclusion: In conclusion, CRKP compared with CSKP is associated with greater risk of mortality. Investigations on ways to better prevent CRKP are urgently needed.

KW - Carbapenem resistance

KW - Kidney transplantation

KW - Klebsiella pneumoniae infection

UR - http://www.scopus.com/inward/record.url?scp=84907951209&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84907951209&partnerID=8YFLogxK

U2 - 10.1111/tid.12276

DO - 10.1111/tid.12276

M3 - Article

VL - 16

SP - 775

EP - 782

JO - Transplant Infectious Disease

JF - Transplant Infectious Disease

SN - 1398-2273

IS - 5

ER -