Published in:
01-11-2018 | Editorial
Treatment and mortality of Klebslella pneumoniae infections in critically ill patients: should we do and predict them better?
Authors:
Matteo Bassetti, Mura Akova, Mario Tumbarello
Published in:
Intensive Care Medicine
|
Issue 11/2018
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Excerpt
The incidence of severe infections caused by Gram negative bacteria continues to increase, particularly with advances in medical care, and remains a major contributor to morbidity and mortality with variation between countries and between hospitals [
1,
2]. The variable mortality rates of patients with severe infections caused by Gram negative bacteria depends largely on antibiotic resistance but also on differences involving the populations analyzed, including those related to age and underlying disease/comorbidity profiles [
3]. Among Enterobacteriaceae,
Klebsiella pneumoniae (Kp) is largely prevalent in patients admitted to acute and long-term care facilities, and has an outstanding propensity to develop antibiotic resistance [
4]. The issue of Kp resistance, initially involving the class of cephalosporins due to the production of extended-spectrum β-lactamases (ESBL), has now been compounded by the emergence of strains that are also resistant to carbapenems [
4,
5]. Kp is currently the most prevalent species among carbapenem-resistant (CR) Enterobacteriaceae, having become endemic in several countries so that the emergence of CR-Kp has been declared an ‘urgent’ and ‘critical’ threat by national and international organizations [
6]. …