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835. Comparison of the outcomes of patients with KPC and NDM-1-producing Enterobacteriaceae
- Source :
- Open Forum Infectious Diseases
- Publication Year :
- 2020
- Publisher :
- Oxford University Press, 2020.
-
Abstract
- Background Carbapenemase-producing Enterobacteriaceae infections are associated with high mortality. We aimed to compare the clinical outcomes of patients with Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae and those with New-Delhi-Metallo-beta-lactamase-1 (NDM-1)-producing Enterobacteriaceae. Methods We performed a retrospective cohort study of all adult patients (> 16 years old) with KPC or NDM-1-producing Enterobacteriaceae isolates in a 2,700-bed tertiary referral hospital in Seoul, South Korea between 2010 and 2019. Primary outcomes were infection within 30 days and 30-day mortality after the first isolation of KPC or NDM-1-producing Enterobacteriaceae. Results A total of 859 patients were identified during the study period. Of them, 475 (55%) were KPC group and 384 (45%) were NDM-1 group. KPC group tended to develop infection within 30 days after first isolation more frequently than NDM-1 group (31% vs. 26%; P = 0.07). Thirty-day mortality was significantly higher in KPC group compared to NDM-1 group (KPC, 17% (81/475) versus NDM-1, 9% (33/384), P < 0.001). Multivariate analysis revealed that APACHE II score (adjusted odds ratio [aOR], 1.12; P < 0.001), solid cancer (aOR, 2.56; P < 0.001), previous carbapenem therapy (aOR, 1.93; P = 0.004), development of infection of KPC or NDM-1-producing Enterobacteriaceae within 30 days (aOR, 2.63; P < 0.001), and KPC-producing Enterobacteriaceae (aOR, 1.62; P = 0.045) were independent risk factors for 30-day mortality. Table 1. Results of analyses of risk factors for 30-day mortality from initial positive culture date in patients with KPC or NDM-1- producing Enterobacteriaceae Figure 1. Kaplan–Meier survival estimates of patients with KPC or NDM-1-producing Enterobacteriaceae for 30-day mortality after first isolation: KPC (continuous line) versus NDM (dotted line). (log-rank test). Conclusion Our study suggests that KPC-producing Enterobacteriaceae is associated with poorer outcome compared to NDM-1-producing Enterobacteriaceae. Therefore, patients with KPC-producing Enterobacteriaceae colonization should be monitored carefully for development of infection, and appropriate antibiotics should be initiated as soon as possible. Disclosures All Authors: No reported disclosures
- Subjects :
- medicine.medical_specialty
biology
business.industry
biochemical phenomena, metabolism, and nutrition
biology.organism_classification
bacterial infections and mycoses
Enterobacteriaceae
Infectious Diseases
AcademicSubjects/MED00290
Oncology
Internal medicine
Poster Abstracts
medicine
polycyclic compounds
business
Subjects
Details
- Language :
- English
- ISSN :
- 23288957
- Volume :
- 7
- Issue :
- Suppl 1
- Database :
- OpenAIRE
- Journal :
- Open Forum Infectious Diseases
- Accession number :
- edsair.doi.dedup.....c896a7171d26fd87ca81185dd1fe242f