Abstract
A matched 1:3 case-control study investigated factors predicting colistin-resistant versus colistin-susceptible KPC-producing Klebsiella pneumoniae acquisition and its impact on patient outcomes. Case patients were more often admitted from other institutions (P = 0.019) and had longer therapy with beta-lactam/beta-lactamase inhibitors (P = 0.002) and higher overall mortality (P = 0.05). All 52 study isolates were clonally related, suggesting horizontal dissemination. None of these parameters independently predicted colistin resistance, which probably occurred in a susceptible KPC-KP strain that was subsequently disseminated horizontally.
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Anti-Bacterial Agents / pharmacology*
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Bacterial Proteins / biosynthesis*
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Bacterial Typing Techniques
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Case-Control Studies
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Cluster Analysis
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Colistin / pharmacology*
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DNA Fingerprinting
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DNA, Bacterial / genetics
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Electrophoresis, Gel, Pulsed-Field
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Female
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Genotype
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Humans
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Klebsiella Infections / drug therapy
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Klebsiella Infections / epidemiology*
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Klebsiella Infections / microbiology
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Klebsiella Infections / mortality
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Klebsiella pneumoniae / classification*
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Klebsiella pneumoniae / isolation & purification
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Klebsiella pneumoniae / pathogenicity*
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Male
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Middle Aged
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Risk Factors
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Treatment Outcome
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beta-Lactamases / biosynthesis*
Substances
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Anti-Bacterial Agents
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Bacterial Proteins
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DNA, Bacterial
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beta-Lactamases
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Colistin