Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae
Abstract Purpose Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention owing to its very limited therapeutic options, and this strain has increased rapidly in recent years. Although it is accepted that drug resistance is associated with increased mortality in general, but some o...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-03-01
|
| Series: | Annals of Clinical Microbiology and Antimicrobials |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12941-017-0191-3 |
| _version_ | 1818571045140955136 |
|---|---|
| author | Liangfei Xu Xiaoxi Sun Xiaoling Ma |
| author_facet | Liangfei Xu Xiaoxi Sun Xiaoling Ma |
| author_sort | Liangfei Xu |
| collection | DOAJ |
| description | Abstract Purpose Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention owing to its very limited therapeutic options, and this strain has increased rapidly in recent years. Although it is accepted that drug resistance is associated with increased mortality in general, but some other studies found no such relationship. To estimate mortality of patients infected with CRKP in general and analyze factors for mortality of this infection, thus, we conducted this systematic review and meta-analysis. Methods A systematic literature review of relevant studies published until December 2015 was conducted. We selected and assessed articles reporting mortality of patients infected with CRKP. Results Pooled mortality was 42.14% among 2462 patients infected with CRKP versus 21.16% in those infected with carbapenem-susceptible K. pneumoniae (CSKP). The mortality of patients with bloodstream infection (BSI) or urinary tract infection was 54.30 and 13.52%, respectively, and 48.9 and 43.13% in patients admitted to the intensive care unit (ICU) or who underwent solid organ transplantation (SOT). Mortality was 47.66% in patients infected with K. pneumoniae carbapenemase-producing K. pneumoniae and 46.71% in those infected with VIM-producing K. pneumoniae. Geographically, mortality reported in studies from North America, South America, Europe, and Asia was 33.24, 46.71, 50.06, and 44.82%, respectively. Conclusions Our study suggests that patients infected with CRKP have higher mortality than those infected with CSKP, especially in association with BSI, ICU admission, or SOT. We also considered that patients’ survival has a close relationship with their physical condition. Our results imply that attention should be paid to CRKP infection, and that strict infection control measures and new antibiotics are required to protect against CRKP infection. |
| first_indexed | 2024-12-14T13:50:20Z |
| format | Article |
| id | doaj.art-bcd7b0e65d884c57970c1e7581d2a613 |
| institution | Directory Open Access Journal |
| issn | 1476-0711 |
| language | English |
| last_indexed | 2024-12-14T13:50:20Z |
| publishDate | 2017-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Annals of Clinical Microbiology and Antimicrobials |
| spelling | doaj.art-bcd7b0e65d884c57970c1e7581d2a6132022-12-21T22:59:08ZengBMCAnnals of Clinical Microbiology and Antimicrobials1476-07112017-03-0116111210.1186/s12941-017-0191-3Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniaeLiangfei Xu0Xiaoxi Sun1Xiaoling Ma2Department of Laboratory Medicine, Anhui Provincial Hospital, Anhui Medical UniversityDepartment of Laboratory Medicine, Anhui Provincial Hospital, Anhui Medical UniversityDepartment of Laboratory Medicine, Anhui Provincial Hospital, Anhui Medical UniversityAbstract Purpose Carbapenem resistant K. pneumoniae (CRKP) has aroused widespread attention owing to its very limited therapeutic options, and this strain has increased rapidly in recent years. Although it is accepted that drug resistance is associated with increased mortality in general, but some other studies found no such relationship. To estimate mortality of patients infected with CRKP in general and analyze factors for mortality of this infection, thus, we conducted this systematic review and meta-analysis. Methods A systematic literature review of relevant studies published until December 2015 was conducted. We selected and assessed articles reporting mortality of patients infected with CRKP. Results Pooled mortality was 42.14% among 2462 patients infected with CRKP versus 21.16% in those infected with carbapenem-susceptible K. pneumoniae (CSKP). The mortality of patients with bloodstream infection (BSI) or urinary tract infection was 54.30 and 13.52%, respectively, and 48.9 and 43.13% in patients admitted to the intensive care unit (ICU) or who underwent solid organ transplantation (SOT). Mortality was 47.66% in patients infected with K. pneumoniae carbapenemase-producing K. pneumoniae and 46.71% in those infected with VIM-producing K. pneumoniae. Geographically, mortality reported in studies from North America, South America, Europe, and Asia was 33.24, 46.71, 50.06, and 44.82%, respectively. Conclusions Our study suggests that patients infected with CRKP have higher mortality than those infected with CSKP, especially in association with BSI, ICU admission, or SOT. We also considered that patients’ survival has a close relationship with their physical condition. Our results imply that attention should be paid to CRKP infection, and that strict infection control measures and new antibiotics are required to protect against CRKP infection.http://link.springer.com/article/10.1186/s12941-017-0191-3CRKPCarbapenem-resistantK. pneumoniaeMortality |
| spellingShingle | Liangfei Xu Xiaoxi Sun Xiaoling Ma Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae Annals of Clinical Microbiology and Antimicrobials CRKP Carbapenem-resistant K. pneumoniae Mortality |
| title | Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae |
| title_full | Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae |
| title_fullStr | Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae |
| title_full_unstemmed | Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae |
| title_short | Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae |
| title_sort | systematic review and meta analysis of mortality of patients infected with carbapenem resistant klebsiella pneumoniae |
| topic | CRKP Carbapenem-resistant K. pneumoniae Mortality |
| url | http://link.springer.com/article/10.1186/s12941-017-0191-3 |
| work_keys_str_mv | AT liangfeixu systematicreviewandmetaanalysisofmortalityofpatientsinfectedwithcarbapenemresistantklebsiellapneumoniae AT xiaoxisun systematicreviewandmetaanalysisofmortalityofpatientsinfectedwithcarbapenemresistantklebsiellapneumoniae AT xiaolingma systematicreviewandmetaanalysisofmortalityofpatientsinfectedwithcarbapenemresistantklebsiellapneumoniae |