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Volume 27, Number 5—May 2021

Characteristics and Clinical Implications of Carbapenemase-Producing Klebsiella pneumoniae Colonization and Infection, Italy

Marianna Rossi, Liliane Chatenoud, Floriana Gona, Isabella Sala, Giovanni Nattino, Alessia D'Antonio, Daniele Castelli, Teresa Itri, Paola Morelli, Sara Bigoni, Chiara Aldieri, Roberto Martegani, Paolo A. Grossi, Cecilia Del Curto, Stefania Piconi, Sara G. Rimoldi, Paola Brambilla, Paolo Bonfanti, Evelyn Van Hauwermeiren, Massimo Puoti, Gianni Gattuso, Chiara Cerri, Mario C. Raviglione, Daniela M. Cirillo, Alessandra Bandera, Andrea GoriComments to Author , and The KPC-Kp Study Group1
Author affiliations: S. Gerardo Hospital, Monza, Italy (M. Rossi, T. Itri, D. Castelli, P. Bonfanti); Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy (L. Chatenoud, I. Sala, G. Nattino, A. D’Antonio); IRCCS San Raffaele Scientific Institute, Milan (F. Gona, C. Del Curto, D.M. Cirillo); Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan (T. Itri, A. Bandera, A. Gori); Humanitas University, Milan (P. Morelli); Papa Giovanni XXIII Hospital, Bergamo, Italy (S. Bigoni); University of Milan San Paolo Hospital, Milan (C. Aldieri); Busto Arsizio Hospital, Busto Arsizio, Italy (R. Martegani); University of Insubria, ASST Sette Laghi-Varese, Italy (P.A. Grossi); ASST Fatebenefratelli Sacco, Milan (S. Piconi, S.G. Rimoldi); Clinic of Infectious Diseases of Istituti Ospedalieri of Cremona, Cremona, Italy (P. Brambilla); University of Milan-Bicocca, Milan (P. Bonfanti); University of Brescia and ASST Spedali Civili, Brescia, Italy (E. Van Hauwermeiren); ASST Grande Ospedale Metropolitano Niguarda, Milan (M. Puoti); Carlo Poma Hospital, Mantova, Italy (G. Gattuso); Hospital of Lodi, Lodi, Italy (C. Cerri); University of Milan, Milan (M.C. Raviglione, A. Bandera, A. Gori)

Main Article

Table 1

Characteristics of patients identified in multicenter surveillance for Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae, Italy*

Characteristics KPC-Kp patients, n = 1,071
M 694 (64.8)
377 (35.2)
Median age (IQR)
72 (61–80)
Ward of isolation
Intensive care unit 275 (25.7)
Infectious diseases 81 (7.6)
Surgery 149 (13.9)
Geriatrics 47 (4.4)
Oncology 34 (3.2)
Hematology 42 (3.9)
Other medical wards
443 (41.4)
KPC-Kp colonization in previous 12 mo 333 (31.1)
Hospitalization in previous 12 mo 865 (80.8)
Antimicrobial therapy in the 30 d before hospitalization 782 (73.0)
Major surgery in the previous 30 d
262 (24.4)
Underlying conditions† 989 (92.3)
Congestive heart failure 192 (17.9)
Peripheral vascular disease 197 (18.4)
Cerebrovascular disease 205 (19.1)
Chronic lung disease 202 (18.9)
Chronic renal failure 304 (28.4)
Cancer 244 (22.8)
163 (15.2)
Charlson index, median (IQR) 6 (4–8)
Central venous catheter at isolation 414 (38.7)
Urinary catheter at isolation 562 (52.5)
Immunosuppressive therapy 209 (19.5)
Days of hospitalization, median (IQR)
25 (14–45)
KPC-Kp acquisition characteristics‡
Severe infection 221 (20.6)
Mild infection 109 (10.2)
741 (69.2)
Median time from hospitalization to isolation of strain, d (IQR)‡
Severe infection 12 (2–22)
Mild infection 11 (2–25)
6 (1–17)
Median time from strain isolation to discharge or death, d (IQR)‡
Severe infection 18 (9–35)
Mild infection 20 (12–35)
Colonizationsur 13 (6–22)

*Values are no. (%) except as indicated. IQR, interquartile range; KPC-Kp, Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae. †Underlying conditions and devices are listed when present in >10% of patients. ‡Severe infection included bloodstream or lower respiratory tract infection plus septic shock from other sites; Mild infection included infections from other sites; and colonizedsur patients were identified through surveillance protocols.

Main Article

1Group collaborators are listed at the end of this article.

Page created: March 05, 2021
Page updated: April 22, 2021
Page reviewed: April 22, 2021
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