國家衛生研究院 NHRI:Item 3990099045/10931
English  |  正體中文  |  简体中文  |  全文笔数/总笔数 : 12145/12927 (94%)
造访人次 : 906198      在线人数 : 793
RC Version 6.0 © Powered By DSPACE, MIT. Enhanced by NTU Library IR team.
搜寻范围 查询小技巧：
  • 您可在西文检索词汇前后加上"双引号"，以获取较精准的检索结果
  • 若欲以作者姓名搜寻，建议至进阶搜寻限定作者字段，可获得较完整数据
    •  进阶搜寻
    主页 ‧ 登入 ‧ 上传 ‧ 说明 ‧ 关于NHRI ‧ 管理 到手机版


    jsp.display-item.identifier=請使用永久網址來引用或連結此文件: http://ir.nhri.org.tw/handle/3990099045/10931


    题名: Predictors of mortality in hospitalized patients with carbapenem-resistant Klebsiella pneumoniae bacteriuria
    作者: Chuang, C;Su, CF;Lin, YT;Wang, FD;Chuang, YC;Siu, LK;Fung, CP
    贡献者: National Institute of Infectious Diseases and Vaccinology
    摘要: Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has been increasingly reported worldwide, but few studies address the clinical significance and outcome of antimicro-bial treatment in CRKP bacteriuria. Methods: We retrospectively collected clinical and microbiological data of patients with monomicrobial CRKP bacteriuria from 16 hospitals in Taiwan during 2013 to 2014. Carbapenem resistance was defined as a minimum inhibitory concentration (MIC) of ≥2 mg/L for imipenem or meropenem. The resistance mechanisms were analyzed. Critically ill patients were those with an Acute Physiology and Chronic Health Evaluation (APACHE) II score ≥ 20. Tigecycline was considered as inappropriate therapy regardless of MIC due to low urine concentration. Multivariate Cox regression analysis was used to determine independent risk factors of 14-day and 28-day mortality. Subgroup analysis for critically ill and non-critically ill patients were performed. Results: Of the 126 hospitalized patients with CRKP bacteriuria, 53 had genes that encoded carbapenemase: KPC-2 (n = 43), KPC-17 (n = 7), VIM-1 (n = 1), IMP-8 (n = 1) and OXA-48 (n = 1). The 14-day and 28-day mortality were 12.7% and 23.0%, respectively. Critically ill patients (n = 53, 42.1%) had significantly higher mortality to non-critically ill patients. Appropriate antimicrobial therapy was used in 33 patients (26.2%). In the multivariate Cox analysis, APACHI II score was the only independent risk factor for 14-day mortality (hazard ratio [HR], 1.15; 95% confidence interval [CI], 1.08–1.22; P < 0.001). APACHI II score (HR, 1.11; 95% CI, 1.06–1.16; P < 0.001) and immunocompomised state (HR, 3.27; 95% CI, 1.21–8.81; P = 0.019) were the independent risk factors for 28-day mortality. We further stratified patients into critically ill and non-critically ill group, and found appropriate antimicrobial therapy was not associated with survival benefit in both groups. Conclusion: Host factors were the predictors for mortality in patients with CRKP bacteriuria. Antimicrobial treatment was not associated with survival benefit in either critically ill or non-critically ill patients. The findings may provide some insight on future antibiotic stewardship interventions.
    日期: 2017-11
    關聯: International Journal of Antimicrobial Agents. 2017 Nov;50(Suppl. 2):S242.
    Link to: http://dx.doi.org/10.1016/S0924-8579(17)30423-5
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0924-8579&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000416028900612
    显示于类别:[蕭樑基] 會議論文/會議摘要

    文件中的档案:

    档案 大小格式浏览次数
    ISI000416028900612.pdf84KbAdobe PDF305检视/开启


    在NHRI中所有的数据项都受到原著作权保护.

    TAIR相关文章

    DSpace Software Copyright © 2002-2004  MIT &  Hewlett-Packard  /   Enhanced by   NTU Library IR team Copyright ©   - 回馈