Table 2.
The clinical characteristics of K. pneumoniae BSIs according to blaKPC and HM phenotype
| Characteristics | blaKPC+/HM+ (n = 3) | blaKPC+/HM− (n = 92) | blaKPC−/HM+ (n = 66) | blaKPC−/HM− (n = 124) | P valuec | P valued | P valuee |
|---|---|---|---|---|---|---|---|
| Demographic data | |||||||
| Age (years), mean (±SD) | 68.0 ± 19.2 | 57.4 ± 15.3 | 57.1 ± 13.9 | 56.0 ± 17.4 | 0.93 | 0.94 | 0.88 |
| Male sex | 2 (66.7) | 68 (73.9) | 44 (66.7) | 85 (68.5) | 0.32 | 0.39 | 0.79 |
| Hospitalization unit | |||||||
| Medical | 0 | 55 (59.8) | 56 (84.8) | 105 (84.7) | 0.001 | < 0.001 | 0.98 |
| ICU | 3 (100) | 37 (40.2) | 10 (15.2) | 19 (15.3) | |||
| Acquisition | |||||||
| Nosocomial | 2 (66.7) | 89 (96.7) | 29 (43.9) | 86 (69.4) | < 0.001 | < 0.001 | 0.001 |
| Community | 1 (33.3) | 3 (3.3) | 37 (56.1) | 38 (30.6) | |||
| Underlying diseases | |||||||
| Diabetes | 0 | 22 (23.9) | 11 (16.7) | 30 (24.2) | 0.27 | 0.96 | 0.23 |
| Hematologic malignancy | 1 (33.3) | 7 (7.6) | 3 (4.5) | 20 (16.1) | 0.52 | 0.06 | 0.02 |
| Solid tumor | 1 (33.3) | 11 (12.0) | 21 (31.8) | 34 (27.4) | 0.002 | 0.006 | 0.52 |
| Solid organ transplantation | 0 | 21 (22.8) | 4 (6.1) | 8 (6.5) | 0.004 | < 0.001 | 0.92 |
| Heart disease | 0 | 16 (17.4) | 8 (12.1) | 11 (8.9) | 0.36 | 0.06 | 0.48 |
| Chronic lung disease | 0 | 10 (10.9) | 10 (15.2) | 8 (6.5) | 0.43 | 0.25 | 0.051 |
| Chronic kidney disease | 1 (33.3) | 31 (33.7) | 8 (12.1) | 22 (17.7) | 0.002 | 0.007 | 0.31 |
| Origin of BSI | |||||||
| Respiratory tract | 2 (66.7) | 29 (31.5) | 7 (10.6) | 11 (8.9) | 0.002 | 0.001 | 0.14 |
| Intraabdominal | 1 (33.3) | 19 (20.7) | 9 (13.6) | 7 (5.6) | 0.26 | 0.001 | 0.06 |
| Soft tissue | 0 | 4 (4.3) | 4 (6.1) | 2 (1.6) | 0.72 | 0.41 | 0.19 |
| Intravenous catheter | 0 | 6 (6.5) | 0 | 4 (3.2) | 0.04 | 0.42 | 0.30 |
| Urinary tract | 0 | 4 (4.3) | 1 (1.5) | 9 (7.3) | 0.40 | 0.37 | 0.18 |
| Biliary tract | 0 | 5 (5.4) | 16 (24.2) | 31 (25) | 0.001 | < 0.001 | 0.91 |
| Liver abscess | 0 | 3 (3.3) | 15 (22.7) | 10 (8.1) | < 0.001 | 0.14 | 0.004 |
| Unknown | 0 | 14 (15.2) | 12 (18.2) | 46 (37.1) | 0.62 | < 0.001 | 0.007 |
| Other(s)a | 0 | 8 (8.7) | 2 (3.0) | 3 (2.4) | 0.20 | 0.08 | 0.80 |
| Clinical presentation | |||||||
| APACHE II score, median (IQR) | 25 (23.5–26.5) | 23 (18–30) | 14 (11–20) | 15 (11–20) | < 0.001 | < 0.001 | 0.96 |
| Pitt bacteremia score, median (IQR) | 4 (3–4.5) | 7 (2–9) | 1 (1–2) | 1 (0–2) | < 0.001 | < 0.001 | 0.60 |
| Charlson comorbidity index, median (IQR) | 2b | 3 (1–4) | 2 (1–3) | 2 (1–4) | 0.56 | 0.40 | 0.81 |
| Septic shock | 2 (66.7) | 46 (50.0) | 10 (15.2) | 11 (8.9) | < 0.001 | < 0.001 | 0.19 |
| MODS | 2 (66.7) | 37 (40.2) | 2 (3.0) | 7 (5.6) | < 0.001 | < 0.001 | 0.65 |
| Immunosuppression state | 1 (33.3) | 45 (48.9) | 8 (12.1) | 40 (32.3) | < 0.001 | 0.013 | 0.002 |
| Therapy | |||||||
| Appropriate empiric therapy | 0 | 33 (35.9) | 60 (90.9) | 96 (77.4) | < 0.001 | < 0.001 | 0.02 |
| Appropriate definitive therapy | 0 | 60 (65.2) | 65 (98.5) | 105 (84.7) | < 0.001 | 0.001 | 0.003 |
| 14-day mortality | 3 (100) | 39 (42.4) | 5 (7.6) | 7 (5.6) | < 0.001 | < 0.001 | 0.84 |
Data are presented as No. (%) unless otherwise specified; boldface, indicates statistical significance (p<0.05)
Abbreviations: HM hypermucoviscous, BSIs bloodstream infections, CNS central nervous system, APACHE Acute Physiology and Chronic Health Evaluation, MODS multiple organ dysfunction syndrome, SD standard deviation, IQR interquartile range
aCentral nervous system infection, 9 cases; mediastinal infection, 1 cases; endocarditis, 3 cases
bThe three cases had same Charlson comorbidity index
cblaKPC+/HM− vs blaKPC−/HM+
dblaKPC+/HM− vs blaKPC−/HM−
eblaKPC−/HM+ vs blaKPC−/HM−