Emerging Infectious Diseases (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 Gori

DOI
https://doi.org/10.3201/eid2705.203662
Journal volume & issue
Vol. 27, no. 5
pp. 1416 – 1426

Abstract

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Klebsiella pneumoniae carbapenemase–producing K. pneumoniae (KPC-Kp) has been endemic in Italy since 2013. In a multicenter cohort study, we investigated various aspects of KPC-Kp among patients, including 15-day mortality rates and delays in adequate therapy. Most (77%) KPC-Kp strains were sequence type (ST) ST512 or ST307. During 2017, KPC-Kp prevalence was 3.26 cases/1,000 hospitalized patients. Cumulative incidence of KPC-Kp acquired >48 hours after hospital admission was 0.68% but varied widely between centers. Among patients with mild infections and noninfected colonized patients, 15-day mortality rates were comparable, but rates were much higher among patients with severe infections. Delays of >4 days in receiving adequate therapy more frequently occurred among patients with mild infections than those with severe infections, and delays were less common for patients with known previous KPC-Kp colonization. Italy urgently needs a concerted surveillance system to control the spread of KPC-Kp.

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