Table 2. Microbiological and clinical characteristics, presentation, treatment features and outcome.
| Characteristics | Episodes, N = 65 | (%) |
|---|---|---|
| Microbiological features | ||
| Previous treated BSIa | 17 | (26.2) |
| Invasive fungal infectionb | 14 | (21.6) |
| Gut colonization by CRKpc (last 180 days) | 19 | (29.2) |
| Source of bacteremia | ||
| Mucosal barrier injury of the gastrointestinal tract | 56 | (86.1) |
| Primary central venous catheter bloodstream infection | 6 | (9.2) |
| Skin and soft tissues infection | 3 | (4.7) |
| Polymicrobial infection d | 6 | (9.2) |
| • Acinetobacter baumanni | 1 | (16.7) |
| • Enterococcus faecalis | 1 | (16.7) |
| • Enterococcus faecium | 1 | (16.7) |
| • Fusarium solani | 1 | (16.7) |
| • Rothia mucilaginosa | 1 | (16.7) |
| • Streptococcus parasanguinis | ||
| Polymyxin B resistant CRKpe | 34 | (52.3) |
| Clinical presentation | ||
| Hypotension on presentation | 26 | (40) |
| Pitt Score ≥ 4 | 10 | (15.4) |
| Demand for intensive care unit | 25 | (38.5) |
| Acute renal failure | 43 | (66.2) |
| Acute renal failure (AKIN II or III) | 27 | (41.5) |
| Treatment attributes | ||
| Appropriate empirical therapy | 31 | (47.7) |
| Appropriate therapy within 3 days | 47 | (72.3) |
| Appropriate definitive therapy | 53 | (81.5) |
| CRKp combination therapy | 33 | (50.8) |
| Number of CRKp-active drugs used in treatment | ||
| • 0 | 12 | (18.4) |
| • 1 | 20 | (30.8) |
| • ≥ 2 | 33 | (50.8) |
| Outcomes | ||
| Underlying disease complications | 11 | (16.9) |
| 14-day mortality | 21 | (32.3) |
| 30-day mortality | 24 | (36.9) |
Microbiological and clinical characteristics, presentation, treatment features and outcome of 65 carbapenem-resistant Klebsiella pneumoniae bloodstream infections among patients with haematological malignances and hematopoietic stem cell transplant recipients. Notes: AKIN–Acute kidney injury network; BSI–Bloodstream infection; CRKp–Carbapenem-resistant Klebsiella pneumoniae; ECOG–Eastern Cooperative Oncology Group; MIC–minimum inhibitory concentration.
aIn the 30 days preceding CRKp-BSI
bOnly probable or proven diagnosed or treated during the episode
cIn the 180 days preceding CRKp-BSI
dProportionally to the number of polymicrobial infections
ePolymyxin B MIC > 2mcg/mL