Article Figures & Data
Figures
- FIG 1
Flow diagram outlining the characteristics of the patients in this study. In each box, the origin of admission for the index hospitalization, the first culture site, and whether the first culture represented infection or colonization are shown.
- FIG 2
(A) Numbers of colonizations and infections per anatomical site of CR K. pneumoniae-positive cultures. Percentages are the proportions of patient with infections. (B) Selected antimicrobial susceptibility rates. Note that breakpoints defined by the CLSI were used for aminoglycosides and criteria set forth by the EUCAST were used for colistin and tigecycline. TMP/SMX, trimethoprim-sulfamethoxazole.
- FIG 3
Kaplan-Meier survival curves showing times from the first positive culture to death in the hospital for patients with CR K. pneumoniae infections by source of infection, censoring at 30 days, or time of discharge, whichever occurred first (P = 0.015 by log rank test).
Tables
- TABLE 1
Demographic characteristics of the patients in this study
Patient characteristic All Infected Colonized Total no. 251 114 137 Median age, yr (IQR) 70 (58–81) 67 (54–81) 73 (64.5–83) No. (%) female 150 (60) 67 (59) 83 (61) No. (%) who were: White, non-Hispanic 145 (58) 63 (55) 82 (60) Black, non-Hispanic 95 (38) 49 (43) 46 (34) Hispanic 7 (3) 2 (2) 5 (4) Other 4 (2) 0 4 (3) No. (%) with: Diabetes mellitus 140 (56) 66 (58) 74 (54) Heart diseasea 142 (57) 62 (55) 80 (58) Renal insufficiency 65 (26) 31 (27) 34 (25) COPDb 73 (29) 30 (27) 43 (31) Malignancy 36 (14) 18 (16) 18 (13) Dementia 54 (22) 22 (19) 32 (23) Immunocompromise 25 (10) 14 (12) 11 (8) Prednisone therapyc 12 (5) 6 (5) 6 (4) Solid-organ transplant 10 (4) 5 (4) 5 (4) HIV infection 2 (1) 2 (2) 0 Hematopoietic stem cell transplant 1 (0) 1 (1) 0 Median Charlson comorbidity index (IQR) 4 (2–6) 4 (2–6) 4 (2–6) No. (%) from: SNF 123 (49) 50 (44) 73 (53) Home 71 (28) 34 (30) 37 (27) Another hospital 32 (13) 20 (18) 12 (8) Long-term acute-care facility 25 (10) 10 (9) 15 (11) - TABLE 2
Outcome of first admission per patienta
Patient characteristic All Infected Colonized P valueb Total no. 251 114 137 No. (%) at following location at time of culture: 0.48 Emergency department 66 (26) 26 (23) 40 (29) Ward 108 (43) 50 (44) 58 (42) ICU 77 (31) 38 (33) 39 (28) Median PBS (IQR) 2 (1–4) 2 (1–4) 2 (0–4) 0.10 Median no. of days to first positive culture (IQR) 1 (0–4) 1 (0–6) 0 (0–4) 0.08 No. (%) with CR K. pneumoniae isolated: Within first 24 h 124 (49) 54 (47) 70 (51) On days 2–5 69 (27) 29 (25) 40 (29) After day 5 58 (23) 31 (27) 27 (20) Median LOS, days (IQR) 9 (5–17) 10 (6–20) 8 (5–15) 0.11 No. (%) with ICU admission 129 (51) 65 (57) 64 (47) 0.13 Median no. of days in ICU (IQR)a 6 (3–15) 7 (3.5–15.5) 6 (3–15) 0.31 No. (%) with: Surgery 60 (24) 38 (33) 22 (16) <0.01 Renal insufficiency 91 (36) 43 (38) 48 (35) 0.69 Renal replacement therapy 46 (18) 24 (21) 22 (16) 0.33 Mechanical ventilation 85 (34) 47 (41) 38 (28) 0.03 Tracheostomy 39 (16) 17 (15) 22 (16) 0.86 No. (%) with following disposition: 0.05 Death/hospice 45 (18) 26 (23) 19 (14) Home 43 (17) 19 (17) 24 (18) SNF 107 (43) 39 (35) 68 (50) Other 56 (22) 30 (26) 26 (19) - TABLE 3
Comparison of patients with rep-PCR type A and B strains
Patient characteristic A B ORa (95% CI) P valueb Total no. 39 52 No. (%) with: Any carbapenemase 39 (100) 51 (98) KPC-2 36 (92) 2 (4) 294.00 (58.16–2552.68) <0.001 KPC-3 3 (7) 49 (96) 0.00 (0.00–0.02) <0.001 No. (%) with isolate from: 0.135 Urine 19 (49) 36 (69) Blood 11 (28) 8 (15) 2.61 (0.90–7.81) Other 9 (23) 8 (15) 2.13 (0.70–6.57) No. (%) infected 22 (56) 27 (51) 1.20 (0.52–2.78) 0.67 No. with susceptible isolates/no. with isolates tested (%) Colistin 32/35 (91) 37/39 (95) 0.57 (0.07–3.69) 0.66 Tigecycline 23/25 (92) 28/41 (68) 5.34 (1.30–36.41) 0.018 Amikacin 7/18 (39) 42/48 (88) 0.09 (0.02–0.31) <0.001 Gentamicin 30/38 (79) 7/52 (13) 24.11 (8.39–79.38) <0.001 Trimethoprim-sulfamethoxazole 9/36 (25) 22/52 (42) 0.45 (0.17–1.13) 0.091 No. (%) from: SNFs 9 (23) 25 (48) 0.043 Home 15 (38) 15 (29) 2.78 (0.99–8.16) Other 15 (38) 12 (23) 3.47 (1.21–10.55) No. (%) with strain present at admission 14 (36) 28 (54) 0.48 (0.20–1.11) 0.088 Median LOS (IQR) 12 (6–32) 8 (5–19.75) 1.02c (1.00–1.04) 0.043 No. (%) with following disposition: Death/hospice 11 (28) 10 (19) 0.72 Home 7 (18) 13 (25) 0.49 (0.13–1.69) SNF 15 (38) 20 (38) 0.68 (0.22–2.02) Other 6 (15) 9 (17) 0.61 (0.15–2.29)
