Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) has been endemic in Italy since 2013. In a multicenter cohort study, we investigated various aspects of KPC-Kp among patients, including 15-day mortality rates and delays in adequate therapy. Most (77%) KPC-Kp strains were sequence types ST512 or ST307. During 2017, KPC-Kp prevalence was 3.26 cases/1,000 hospitalized patients. Cumulative incidence of KPC-Kp acquired >48 hours after hospital admission was 0.68% but varied widely between centers. Among patients with mild infections and noninfected colonized patients, 15-day mortality rates were comparable, but rates were much higher among patients with severe infections. Delays of >4 days in receiving adequate therapy more frequently occurred among patients with mild infections than those with severe infections, and delays were less common for patients with known previous KPC-Kp colonization. Italy urgently needs a concerted surveillance system to control the spread of KPC-Kp.
Characteristics and clinical implications of carbapenemase-producing klebsiella pneumoniae colonization and infection, Italy / M. Rossi, L. Chatenoud, F. Gona, I. Sala, G. Nattino, A. D'Antonio, D. Castelli, T. Itri, P. Morelli, S. Bigoni, C. Aldieri, R. Martegani, P.A. Grossi, C. Del Curto, S. Piconi, S.G. Rimoldi, P. Brambilla, P. Bonfanti, E. van Hauwermeiren, M. Puoti, G. Gattuso, C. Cerri, M.C. Raviglione, D.M. Cirillo, A. Bandera, A. Gori, S. Battaglia, G. Lorenzin, A. Cavallero, M. Casana, D. Pocaterra, A. Cona, A. D'Arminio Monforte, G. Brigante, A. Carducci, D. Dalla Gasperina, C. Rovelli, M. Moro, P. Scarpellini, G. Rizzardini, A. Pan, A. Zoncada, M. Franzetti, A. Pandolfo, F. Castelli, E. Pollastri, G. Travi, C.S. Vismara, S. Garilli, M. Piazza, A. Regazzetti, M. Arghittu, R.M. Colombo, P. Olivieri, F. Petri, F. Averara, F. Vailati. - In: EMERGING INFECTIOUS DISEASES. - ISSN 1080-6040. - 27:5(2021 May), pp. 1416-1426. [10.3201/eid2705.203662]
Characteristics and clinical implications of carbapenemase-producing klebsiella pneumoniae colonization and infection, Italy
L. ChatenoudSecondo
;A. D'Antonio;C. Aldieri;R. Martegani;C. Del Curto;S. Piconi;S.G. Rimoldi;P. Bonfanti;M.C. Raviglione;A. Bandera;A. Gori;S. Battaglia;M. Casana;A. Cona;A. D'Arminio Monforte;C. Rovelli;A. Pandolfo;C.S. Vismara;M. Arghittu;F. Petri;
2021
Abstract
Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) has been endemic in Italy since 2013. In a multicenter cohort study, we investigated various aspects of KPC-Kp among patients, including 15-day mortality rates and delays in adequate therapy. Most (77%) KPC-Kp strains were sequence types ST512 or ST307. During 2017, KPC-Kp prevalence was 3.26 cases/1,000 hospitalized patients. Cumulative incidence of KPC-Kp acquired >48 hours after hospital admission was 0.68% but varied widely between centers. Among patients with mild infections and noninfected colonized patients, 15-day mortality rates were comparable, but rates were much higher among patients with severe infections. Delays of >4 days in receiving adequate therapy more frequently occurred among patients with mild infections than those with severe infections, and delays were less common for patients with known previous KPC-Kp colonization. Italy urgently needs a concerted surveillance system to control the spread of KPC-Kp.
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