Factors influencing mortality in intracranial infections caused by carbapenem-resistant Klebsiella Pneumoniae.
Carbapenem-resistant Klebsiella Pneumoniae
Carbapenem-susceptive Klebsiella Pneumoniae
Intracranial infection
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
05 Sep 2024
05 Sep 2024
Historique:
received:
29
05
2024
accepted:
29
08
2024
medline:
6
9
2024
pubmed:
6
9
2024
entrez:
5
9
2024
Statut:
epublish
Résumé
It remains that intracranial infection has an alarming mortality and morbidity. Klebsiella pneumoniae (KP) have increasingly been isolated in ventriculitis and meningitis episodes. Intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) account for high mortality. To understand its clinical impact and related risk factors accurately are crucial in the management of bacterial intracranial infection. The retrospective study aimed to delineate the clinical risk of death from intracranial infection and analyze the risk factors. A total of 176 Klebsiella pneumoniae intracranial infectious patients were available to divide into CRKP group and carbapenem-susceptive Klebsiella Pneumoniae (CSKP) group. We performed survival analysis and estimate the time-varying effects of CRKP and CSKP infection on 30-day mortality. Infectious patients caused by CSKP was associated with lower mortality than CRKP group. The risk factors associated with death from intracranial infection caused by Klebsiella pneumoniae included SOFA scores, ventilator therapy, CRKP, and heart failure. Longer hospital stays are independently associated with lower mortality rates. Intracranial infection caused by CRKP was associated with excess mortality. Complex comorbidities mean higher mortality. Active supportive treatment is required for complicated patients with intracranial infections caused by carbapenem-resistant Klebsiella pneumoniae.
Identifiants
pubmed: 39237686
doi: 10.1038/s41598-024-71660-4
pii: 10.1038/s41598-024-71660-4
doi:
Substances chimiques
Carbapenems
0
Anti-Bacterial Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
20670Subventions
Organisme : Young and Middle-aged Scientific Technological Innovation Jie-Qing Talent Project
ID : YXKC2021042
Organisme : Henan Province Key Medical Science and Technology Research Project Co-established by Provincial and Ministerial Authorities (CN)
ID : SBGJ202102081
Organisme : Henan Province Science and Technology Research Project (CN)
ID : 242102311040
Organisme : Henan Province Natural Science Foundation Project (CN)
ID : 242300420384
Informations de copyright
© 2024. The Author(s).
Références
Carlson, R. D. et al. Predictors of neurocognitive outcomes on antiretroviral therapy after cryptococcal meningitis: A prospective cohort study. Metab. Brain Dis. 29(2), 269–279. https://doi.org/10.1007/s11011-013-9476-1 (2014).
doi: 10.1007/s11011-013-9476-1
pubmed: 24399496
pmcid: 4033836
Jacob, S. S. & Top, F. H. Friedländer bacillus meningitis; report of seven cases with two recoveries. Ann. Intern. Med. 28(5), 1003–1009. https://doi.org/10.7326/0003-4819-28-5-1003 (1948).
doi: 10.7326/0003-4819-28-5-1003
pubmed: 18858402
Tangden, T. & Giske, C. G. Global dissemination of extensively drug-resistant carbapenemase-producing Enterobacteriaceae: Clinical perspectives on detection, treatment and infection control. J. Intern. Med. 277, 501–512. https://doi.org/10.1111/joim.12342 (2015).
doi: 10.1111/joim.12342
pubmed: 25556628
Lu, C. H., Chang, W. N. & Chang, H. W. Klebsiella meningitis in adults: Clinical features, prognostic factors and therapeutic outcomes. J. Clin. Neurosci. Off. J. Neurosurg. Soc. Australas. 9(5), 533–538. https://doi.org/10.1054/jocn.2001.1032.( (2002).
doi: 10.1054/jocn.2001.1032.(
Zhao, J. et al. Klebsiella pneumoniae-related brain abscess and meningitis in adults: Case report. Medicine 101(2), e28415. https://doi.org/10.1097/MD.0000000000028415 (2022).
doi: 10.1097/MD.0000000000028415
pubmed: 35029179
pmcid: 8757935
Bardak-Ozcem, S. & Sipahi, O. R. An updated approach to healthcare-associated meningitis. Expert Rev. Anti-infect. Ther. 12(3), 333–342. https://doi.org/10.1586/14787210.2014.890049 (2014).
doi: 10.1586/14787210.2014.890049
pubmed: 24512210
Tunkel, A. R. et al. 2017 Infectious Diseases Society of America’s clinical practice guidelines for healthcare-associated ventriculitis and meningitis*. Clin. Infect. Dis. 64, e34–e65. https://doi.org/10.1093/cid/ciw861 (2017).
doi: 10.1093/cid/ciw861
pubmed: 28203777
pmcid: 5848239
Pandey, S. et al. Clinical characteristics of hydrocephalus following the treatment of pyogenic ventriculitis caused by multi/extensive drug-resistant gram-negative Bacilli, Acinetobacter Baumannii, and Klebsiella Pneumoniae. Front. Surg. 9, 854627. https://doi.org/10.3389/fsurg.2022.854627 (2022).
doi: 10.3389/fsurg.2022.854627
pubmed: 35592123
pmcid: 9110772
Wang, H., Zhou, Q., Huang, K., Yang, X. & Wen, L. Intraventricular plus systemic antibiotic therapy for treating Polymyxin-resistant Klebsiella pneumoniae ventriculitis: A case report. Open Forum Infect. Dis. 9, ofac084. https://doi.org/10.1093/ofid/ofac084 (2022).
doi: 10.1093/ofid/ofac084
pubmed: 35355891
pmcid: 8962704
ValienteDeSantis, L. B. et al. Nosocomial meningitis caused by ESBL- and OXA-48-producing Klebsiella pneumoniae and treated with ceftazidime-avibactam. Report of one case and review of the literature. Revista espanola de quimioterapia: publicacion oficial de la Sociedad Espanola de Quimioterapia 35, 572–576. https://doi.org/10.37201/req/043.2022 (2022).
doi: 10.37201/req/043.2022
Brook, I., Bricknell, K. S., Overturf, G. D. & Finegold, S. M. Measurement of lactic acid in cerebrospinal fluid of patients with infections of the central nervous system. J. Infect. Dis. 137(4), 384–390. https://doi.org/10.1093/infdis/137.4.384 (1978).
doi: 10.1093/infdis/137.4.384
pubmed: 649985
Giske, C. G., Turnidge, J., Cantón, R., Kahlmeter, G., Committee. E. S. Update from the European Committee on Antimicrobial Susceptibility Testing (EUCAST). J. Clin. Microbiol. 60(3), e0027621. https://doi.org/10.1128/JCM.00276-21 (2022).
doi: 10.1128/JCM.00276-21
pubmed: 34346716
Bobenchik, A. M., Deak, E., Hindler, J. A., Charlton, C. L. & Humphries, R. M. Performance of Vitek 2 for antimicrobial susceptibility testing of Enterobacteriaceae with Vitek 2 (2009 FDA) and 2014 CLSI breakpoints. J. Clin. Microbiol. 53(3), 816–823. https://doi.org/10.1128/JCM.02697-14 (2015).
doi: 10.1128/JCM.02697-14
pubmed: 25540403
pmcid: 4390649
Yadegarynia, D. et al. Changing pattern of infectious agents in postneurosurgical meningitis. Casp. J. Intern. Med. 5(3), 170–175 (2014).
Tian, R., Hao, S., Hou, Z., Gao, Z. & Liu, B. The characteristics of post-neurosurgical bacterial meningitis in elective neurosurgery in 2012: A single institute study. Clin. Neurol. Neurosurg. 139, 41–45. https://doi.org/10.1016/j.clineuro.2015.09.002 (2015).
doi: 10.1016/j.clineuro.2015.09.002
pubmed: 26364156
Shi, Z. H. et al. Post-craniotomy intracranial infection in patients with brain tumors: A retrospective analysis of 5723 consecutive patients. Br. J. Neurosurg. 31(1), 5–9. https://doi.org/10.1080/02688697.2016.1253827 (2017).
doi: 10.1080/02688697.2016.1253827
pubmed: 27845572
Zhan, R. et al. Post-operative central nervous system infections after cranial surgery in China: Incidence, causative agents, and risk factors in 1,470 patients. Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol. 33(5), 861–866. https://doi.org/10.1007/s10096-013-2026-2 (2014).
doi: 10.1007/s10096-013-2026-2
Nussinovitch, M. et al. Cerebrospinal fluid lactate dehydrogenase isoenzymes in children with bacterial and aseptic meningitis. Transl. Res. 154, 214–218. https://doi.org/10.1016/j.trsl.2009.06.011 (2009).
doi: 10.1016/j.trsl.2009.06.011
pubmed: 19766965
Shon, A. S., Bajwa, R. P. & Russo, T. A. Hypervirulent (hypermucoviscous) Klebsiella pneumoniae: A new and dangerous breed. Virulence 4(2), 107–118. https://doi.org/10.4161/viru.22718 (2013).
doi: 10.4161/viru.22718
pubmed: 23302790
pmcid: 3654609
Lee, H. L., Lee, H. C., Guo, H. R., Ko, W. C. & Chen, K. W. Clinical significance and mechanism of gas formation of pyogenic liver abscess due to Klebsiella pneumoniae. J. Clin. Microbiol. 42(6), 2783–2785. https://doi.org/10.1128/JCM.42.6.2783-2785.2004 (2004).
doi: 10.1128/JCM.42.6.2783-2785.2004
pubmed: 15184470
pmcid: 427832
Hsieh, D. Y. et al. Sex-based differences in bacterial meningitis in adults: Epidemiology, clinical features, and therapeutic outcomes. J. Infect. Public Health 14(9), 1218–1225. https://doi.org/10.1016/j.jiph.2021.08.018 (2021).
doi: 10.1016/j.jiph.2021.08.018
pubmed: 34438332
Li, Y. et al. Convergence of carbapenem resistance and hypervirulence leads to high mortality in patients with postoperative Klebsiella pneumoniae meningitis. J. Glob. Antimicrob. Resist. 27, 95–100. https://doi.org/10.1016/j.jgar.2021.02.035( (2021).
doi: 10.1016/j.jgar.2021.02.035(
pubmed: 34133987
Kastenbauer, S. & Pfister, H. W. Pneumococcal meningitis in adults: spectrum of complications and prognostic factors in a series of 87 cases. Brain 126(Pt 5), 1015–1025. https://doi.org/10.1093/brain/awg113 (2003).
doi: 10.1093/brain/awg113
pubmed: 12690042
Han, J. H. et al. Epidemiology of Carbapenem-Resistant Klebsiella pneumoniae in a Network of Long-Term Acute Care Hospitals. Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 64(7), 839–844. https://doi.org/10.1093/cid/ciw856 (2017).
doi: 10.1093/cid/ciw856
Fang, C. T. et al. Klebsiella pneumoniae genotype K1: An emerging pathogen that causes septic ocular or central nervous system complications from pyogenic liver abscess. Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am. 45(3), 284–293. https://doi.org/10.1086/519262 (2007).
doi: 10.1086/519262