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Purpose: Klebsiella pneumoniae carbapenemase (KPC) and New Delhi metallo-β-lactamase (NDM) co-producing carbapenem-resistant Klebsiella pneumoniae (KPC-NDM-CRKP) isolates have been increasingly reported worldwide but have not yet been systematically studied. Thus, we have conducted a study to compare the risk factors, molecular characteristics, and mortality involved in clinical bloodstream infections (BSIs) caused by KPC-NDM-CRKP and KPC-CRKP strains.

Methods: A retrospective study was conducted on 231 patients with BSIs caused by CRKP at Jinling Hospital in China from January 2020 to December 2022. Antimicrobial susceptibility testing, carbapenemase genes detection and whole-genome sequencing were performed subsequently.

Results: Overall, 231 patients were included in this study: 25 patients with KPC-NDM-CRKP BSIs and 206 patients with KPC-CRKP BSIs. Multivariate analysis implicated ICU-acquired BSI, surgery within 30 days, and longer stay of hospitalization prior to CRKP isolation as independent risk factors for KPC-NDM-CRKP BSIs. The 30-day mortality rate of the KPC-NDM-CRKP BSIs group was 56% (14/25) compared with 32.5% (67/206) in the KPC-CRKP BSIs control group ( P = 0.02). The ICU-acquired BSIs, APACHE II score at BSI onset, and BSIs caused by KPC-NDM-CRKP were independent predictors for 30-day mortality in patients with CRKP bacteremia. The most prevalent ST in KPC-NDM-CRKP isolates was ST11 (23/25, 92%), followed by ST15 (2/25, 8%).

Conclusion: In patients with CRKP BSIs, KPC-NDM-CRKP was associated with an excess of mortality. The likelihood that KPC-NDM-CRKP will become the next "superbug" highlights the significance of epidemiologic surveillance and clinical awareness of this pathogen.

Competing Interests: The authors report no conflicts of interest in this work.

Titel:	Clinical and Molecular Characteristics of Patients with Bloodstream Infections Caused by KPC and NDM Co-Producing Carbapenem-Resistant Klebsiella pneumoniae .
Autor/in / Beteiligte Person:	Li, J ; Wu, W ; Wu, M ; Zhou, Z ; Wang, J ; Qiu, M ; Xu, L ; Ren, J ; Wu, X
Link:	Zum Volltext
Zeitschrift:	Infection and drug resistance, Jg. 17 (2024-05-02), S. 1685
Veröffentlichung:	Auckland, N.Z. : Dove Medical Press, 2008-, 2024
Medientyp:	academicJournal
ISSN:	1178-6973 (print)
DOI:	10.2147/IDR.S455146
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Infect Drug Resist] 2024 May 02; Vol. 17, pp. 1685-1697. <i>Date of Electronic Publication: </i>2024 May 02 (<i>Print Publication: </i>2024). References: Lancet Infect Dis. 2022 Jan;22(1):e28-e34. (PMID: 34246322) ; Eur J Clin Microbiol Infect Dis. 2023 May;42(5):529-541. (PMID: 36856898) ; Nucleic Acids Res. 2020 Jan 8;48(D1):D517-D525. (PMID: 31665441) ; Antibiotics (Basel). 2020 Nov 19;9(11):. (PMID: 33228012) ; Lancet Infect Dis. 2022 Mar;22(3):401-412. (PMID: 34767753) ; Infect Drug Resist. 2023 May 18;16:3109-3116. (PMID: 37228660) ; Crit Care. 2020 Jan 30;24(1):29. (PMID: 32000834) ; Clin Infect Dis. 2018 Jan 6;66(2):163-171. (PMID: 29020404) ; Clin Infect Dis. 2022 Sep 29;75(6):1081-1084. (PMID: 35148378) ; Infect Drug Resist. 2023 Oct 17;16:6725-6733. (PMID: 37868700) ; Front Cell Infect Microbiol. 2021 Jul 20;11:658070. (PMID: 34354959) ; Expert Rev Anti Infect Ther. 2024 Apr;22(4):203-209. (PMID: 38258529) ; Trends Microbiol. 2023 Jul;31(7):735-748. (PMID: 36858862) ; J Infect. 2018 May;76(5):438-448. (PMID: 29477802) ; Front Microbiol. 2023 Jul 19;14:1219733. (PMID: 37538843) ; J Antimicrob Chemother. 2019 May 1;74(5):1233-1240. (PMID: 30843067) ; Nat Commun. 2023 Apr 28;14(1):2464. (PMID: 37117217) ; Microbiol Spectr. 2023 Jan 31;:e0278622. (PMID: 36719204) ; Clin Infect Dis. 2024 Jan 25;78(1):31-39. (PMID: 37633257) ; Infect Drug Resist. 2022 Feb 22;15:569-579. (PMID: 35228807) ; J Clin Microbiol. 2020 Jun 24;58(7):. (PMID: 32376668) ; Clin Infect Dis. 2021 Dec 1;73(Suppl_4):S290-S299. (PMID: 34850835) ; Nat Commun. 2021 Jul 7;12(1):4188. (PMID: 34234121) ; JAMA. 2016 Feb 23;315(8):801-10. (PMID: 26903338) ; Eur J Clin Microbiol Infect Dis. 2018 Apr;37(4):679-689. (PMID: 29238932) ; Euro Surveill. 2023 Nov;28(47):. (PMID: 37997662) ; Clin Infect Dis. 2023 Jun 16;76(12):2059-2069. (PMID: 36801828) ; Euro Surveill. 2021 Nov;26(46):. (PMID: 34794535) ; Emerg Infect Dis. 2023 Nov;29(11):2246-2256. (PMID: 37877525) ; Emerg Infect Dis. 2021;27(9):2475-2479. (PMID: 34424168) ; Clin Infect Dis. 2020 Apr 15;70(9):1799-1808. (PMID: 31400759) ; Intensive Care Med. 2022 Nov;48(11):1573-1581. (PMID: 36129475) ; J Antimicrob Chemother. 2023 Aug 2;78(8):1948-1954. (PMID: 37325878) ; J Antimicrob Chemother. 2020 Dec 1;75(12):3491-3500. (PMID: 32780112) ; Infect Drug Resist. 2023 Apr 17;16:2247-2258. (PMID: 37090038) ; EBioMedicine. 2020 Jan;51:102599. (PMID: 31911273) ; Front Microbiol. 2021 Jan 15;11:609856. (PMID: 33519761) ; Microbiol Spectr. 2022 Dec 21;10(6):e0253922. (PMID: 36205391) ; BMC Microbiol. 2023 Mar 7;23(1):64. (PMID: 36882683) ; Clin Infect Dis. 2023 Jul 18;:. (PMID: 37463564) ; J Infect. 2022 May;84(5):637-647. (PMID: 35301013) ; Infect Drug Resist. 2023 Nov 29;16:7351-7363. (PMID: 38050629) ; Open Forum Infect Dis. 2023 Jan 31;10(2):ofad046. (PMID: 36846612) ; Clin Microbiol Rev. 2019 Jan 30;32(2):. (PMID: 30700432) ; Lancet Infect Dis. 2022 Jun;22(6):761-762. (PMID: 35643096) Contributed Indexing: Keywords: Bloodstream infections; KPC and NDM co-producing carbapenem-resistant Klebsiella pneumoniae; molecular characteristics; mortality; risk factors Entry Date(s): Date Created: 20240507 Latest Revision: 20240508 Update Code: 20240508 PubMed Central ID: PMC11073536

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Clinical and Molecular Characteristics of Patients with Bloodstream Infections Caused by KPC and NDM Co-Producing Carbapenem-Resistant Klebsiella pneumoniae .