11 research outputs found
MIC distribution and polymyxin B resistance in carbapenem-resistant <i>Klebsiella pneumoniae</i>, January 2010—December 2019.
Minimum inhibitory concentrations distribution and proportion of polymyxin B resistance among carbapenem-resistant Klebsiella pneumoniae isolates from January 2010 to December 2019. (A) Absolute number of samples distributed according to the minimum inhibitory concentrations obtained by broth microdilution of 45 carbapenem-resistant Klebsiella pneumoniae isolates. Susceptibility (light grey), resistance (dark grey). (B) Percentages of susceptible (light grey) and resistant (dark grey) polymyxin B isolates amidst 65 episodes of carbapenem-resistant Klebsiella pneumoniae bloodstream infections, yearly stratified. Notes: CRKp—carbapenem-resistant Klebsiella pneumonia; MIC–Minimum inhibitory concentration.</p
Antimicrobial susceptibility of <i>Klebsiella pneumoniae</i> isolates.
Antimicrobial susceptibility of Klebsiella pneumoniae isolates.</p
Clinical and demographical characteristics of patients.
Clinical and demographical characteristics of patients.</p
Gram-negative spectrum antimicrobials used as definitive treatment.
The figure illustrates all regimens adopted as definitive treatment for CRKp-BSI during the 10-year span of the study, highlighting the dynamic nature and diversity of therapeutic decisions. All GNB-spectrum antimicrobials used for more than one day were included. The use of a single CRKp active drug throughout the episode was categorized as monotherapy, while combination therapy encompassed the simultaneous use of two or more CRKp active drugs. Treatment was considered inappropriate if it did not include a CRKp active drug. Each line in the figure represents selected antimicrobials used for a single patient. A black square indicates that a drug was used as an active agent, grey squares denote that the drug was part of the definitive therapy despite its in vitro resistance, and white squares correspond to drugs not used in the definitive treatment. Notes: AMK: amikacin; CAV: Ceftazidime-avibactam; CT: combination therapy; GEN: Gentamicin; IN: inappropriate definitive therapy; MER: meropenem; MT: monotherapy; PB: polymyxin B; TIG: tigecycline; FOS: fosfomycin. (TIF)</p
Minimal dataset.
Dataset containing information used in the study analysis, for each participant. Original data, in Portuguese, was translated to English. (XLSX)</p
Graphical timeline: Gram-negative spectrum antimicrobials used as empirical treatment.
The figure illustrates the empirical treatment choices made in the 65 episodes of CRKp-BSI over the 10-year study period, highlighting the dynamic and diverse nature of therapeutic decisions. Each row represents an antimicrobial used as empirical treatment given the episode’s number, yearly stratified (columns). *episode #10 did not received empirical treatment since it was non-neutropenic or had any signs of organ disfunction; antimicrobial therapy was started right after the outcome of initial microbiological tests.</p
Bivariate analysis of predisposing factors associated with increased risk of death within 30 days.
Bivariate analysis of predisposing factors associated with increased risk of death within 30 days.</p
Forest plot of 30-day survival modifiers in carbapenem-resistant <i>Klebsiella pneumoniae</i> bloodstream infections.
Attributable risk factors for 30-day mortality in 65 episodes of CRKp-BSI infection, according to the best fitted model. Hazard ratios (and its 95% confidence interval) values below one denotes a positive correlation with survival whereas values above are associated with mortality. Notes: AIC–Akaike information criteria. All variance inflation factor values of those variables included in the final multivariate model were less than 1.5.</p
Factors associated with 30-day survival according to multivariate Cox regression model.
Factors associated with 30-day survival according to multivariate Cox regression model.</p
Microbiological and clinical characteristics, presentation, treatment features and outcome.
Microbiological and clinical characteristics, presentation, treatment features and outcome.</p