Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy

Patrizia Chiusolo; Simona Sica; C. Girmenia; G. M. Rossolini; A. Piciocchi; A. Bertaina; G. Pisapia; D. Pastore; A. Severino; L. Cudillo; F. Ciceri; R. Scimè; L. Lombardini; C. Viscoli; A. Rambaldi; Marco Frigeni; Alessandro Rambaldi; Consuelo Corti; Fabio Ciceri; Gabriella Mometto; Claudio Annaloro; Erminia Casari; Luca Castagna; Giuseppe Rossi; Chiara Cattaneo; Domenico Russo; Valeria Cancelli; Emilio Paolo Alessandrino; Francesco Ripamonti; Fabio Pavan; Attilio Rovelli; Clara Pecoraro; Alessandro Busca; Francesca Carraro; Franca Fagioli; Susanna Gallo; Daniele Caravelli; Marco De Gobbi; Giuseppe Saglio; Claudia Castellino; Nicola Mordini; Gianluca Gaidano; Luca Nassi; Roberto Raimondi; Michele Vespignani; Anna Maria Scattolin; Irene Sara Panizzolo; Simone Cesaro; Anna Candoni; Francesca Patriarca; Andrea Bacigalupo; Annamaria Raiola; Elio Castagnola; Edoardo Lanino; Marta Stanzani; Giuseppe Bandini; Erika Massaccesi; Arcangelo Prete; Simona Bassi; Daniele Vallisa; Cecilia Caramatti; Franco Aversa; Eliana Zuffa; Stefano Guidi; Alberto Bosi; Veronica Tintori; Anna Paola Iori; Saveria Capria; Laura Cudillo; William Arcese; Teresa Dentamaro; Paolo De Fabritiis; Barbara Anaclerico; Anna Chierichini; Monica Piedimonte; Antonella Ferrari; Francesco Marchesi; Andrea Mengarelli; Elisabetta Cerchiara; Maria Cristina Tirindelli; Javid Gaziev; Alessandro Severino; Ignazio Majolino; Alice Bertaina; Barbarella Lucarelli; Maria Speranza Massei; Alessandra Carotti; Katia Perruccio; Maurizio Caniglia; Stella Santarone; Paolo Di Bartolomeo; Serena Mazzotta; Piero Galieni; Attilio Olivieri; Gennaro De Rosa; Antonio Risitano; Mario Delia; Giorgina Specchia; Giulia Palazzo; Giovanni Pisapia; Giuseppe Messina; Giuseppe Irrera; Emanuele Angelucci; Donatella Baronciani; Adriana Vacca; Alessandra Crescimanno; Maurizio Musso; Rosanna Scimè; Alida Imbriani; Giuseppe Milone

doi:10.1038/bmt.2014.231

Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy

Patrizia Chiusolo, Simona Sica, C. Girmenia, G. M. Rossolini, A. Piciocchi, A. Bertaina, G. Pisapia, D. Pastore, A. Severino, L. Cudillo, F. Ciceri, R. Scimè, L. Lombardini, C. Viscoli, A. Rambaldi, Marco Frigeni, Alessandro Rambaldi, Consuelo Corti, Fabio Ciceri, Gabriella MomettoClaudio Annaloro, Erminia Casari, Luca Castagna, Giuseppe Rossi, Chiara Cattaneo, Domenico Russo, Valeria Cancelli, Emilio Paolo Alessandrino, Francesco Ripamonti, Fabio Pavan, Attilio Rovelli, Clara Pecoraro, Alessandro Busca, Francesca Carraro, Franca Fagioli, Susanna Gallo, Daniele Caravelli, Marco De Gobbi, Giuseppe Saglio, Claudia Castellino, Nicola Mordini, Gianluca Gaidano, Luca Nassi, Roberto Raimondi, Michele Vespignani, Anna Maria Scattolin, Irene Sara Panizzolo, Simone Cesaro, Anna Candoni, Francesca Patriarca, Andrea Bacigalupo, Annamaria Raiola, Elio Castagnola, Edoardo Lanino, Marta Stanzani, Giuseppe Bandini, Erika Massaccesi, Arcangelo Prete, Simona Bassi, Daniele Vallisa, Cecilia Caramatti, Franco Aversa, Eliana Zuffa, Stefano Guidi, Alberto Bosi, Veronica Tintori, Anna Paola Iori, Saveria Capria, Laura Cudillo, William Arcese, Teresa Dentamaro, Paolo De Fabritiis, Barbara Anaclerico, Anna Chierichini, Monica Piedimonte, Antonella Ferrari, Francesco Marchesi, Andrea Mengarelli, Elisabetta Cerchiara, Maria Cristina Tirindelli, Javid Gaziev, Alessandro Severino, Ignazio Majolino, Alice Bertaina, Barbarella Lucarelli, Maria Speranza Massei, Alessandra Carotti, Katia Perruccio, Maurizio Caniglia, Stella Santarone, Paolo Di Bartolomeo, Serena Mazzotta, Piero Galieni, Attilio Olivieri, Gennaro De Rosa, Antonio Risitano, Mario Delia, Giorgina Specchia, Giulia Palazzo, Giovanni Pisapia, Giuseppe Messina, Giuseppe Irrera, Emanuele Angelucci, Donatella Baronciani, Adriana Vacca, Alessandra Crescimanno, Maurizio Musso, Rosanna Scimè, Alida Imbriani, Giuseppe Milone

Research output: Contribution to journal › Article

94 Citations (Scopus)

Abstract

Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

Original language	English
Pages (from-to)	1-7
Number of pages	7
Journal	Bone Marrow Transplantation
DOIs	https://doi.org/10.1038/bmt.2014.231
Publication status	Published - 2014

Keywords

infection

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10.1038/bmt.2014.231

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Chiusolo, P., Sica, S., Girmenia, C., Rossolini, G. M., Piciocchi, A., Bertaina, A., Pisapia, G., Pastore, D., Severino, A., Cudillo, L., Ciceri, F., Scimè, R., Lombardini, L., Viscoli, C., Rambaldi, A., Frigeni, M., Rambaldi, A., Corti, C., Ciceri, F., ... Milone, G. (2014). Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy. Bone Marrow Transplantation, 1-7. https://doi.org/10.1038/bmt.2014.231

Chiusolo, Patrizia ; Sica, Simona ; Girmenia, C. ; Rossolini, G. M. ; Piciocchi, A. ; Bertaina, A. ; Pisapia, G. ; Pastore, D. ; Severino, A. ; Cudillo, L. ; Ciceri, F. ; Scimè, R. ; Lombardini, L. ; Viscoli, C. ; Rambaldi, A. ; Frigeni, Marco ; Rambaldi, Alessandro ; Corti, Consuelo ; Ciceri, Fabio ; Mometto, Gabriella ; Annaloro, Claudio ; Casari, Erminia ; Castagna, Luca ; Rossi, Giuseppe ; Cattaneo, Chiara ; Russo, Domenico ; Cancelli, Valeria ; Alessandrino, Emilio Paolo ; Ripamonti, Francesco ; Pavan, Fabio ; Rovelli, Attilio ; Pecoraro, Clara ; Busca, Alessandro ; Carraro, Francesca ; Fagioli, Franca ; Gallo, Susanna ; Caravelli, Daniele ; De Gobbi, Marco ; Saglio, Giuseppe ; Castellino, Claudia ; Mordini, Nicola ; Gaidano, Gianluca ; Nassi, Luca ; Raimondi, Roberto ; Vespignani, Michele ; Scattolin, Anna Maria ; Panizzolo, Irene Sara ; Cesaro, Simone ; Candoni, Anna ; Patriarca, Francesca ; Bacigalupo, Andrea ; Raiola, Annamaria ; Castagnola, Elio ; Lanino, Edoardo ; Stanzani, Marta ; Bandini, Giuseppe ; Massaccesi, Erika ; Prete, Arcangelo ; Bassi, Simona ; Vallisa, Daniele ; Caramatti, Cecilia ; Aversa, Franco ; Zuffa, Eliana ; Guidi, Stefano ; Bosi, Alberto ; Tintori, Veronica ; Iori, Anna Paola ; Capria, Saveria ; Cudillo, Laura ; Arcese, William ; Dentamaro, Teresa ; De Fabritiis, Paolo ; Anaclerico, Barbara ; Chierichini, Anna ; Piedimonte, Monica ; Ferrari, Antonella ; Marchesi, Francesco ; Mengarelli, Andrea ; Cerchiara, Elisabetta ; Tirindelli, Maria Cristina ; Gaziev, Javid ; Severino, Alessandro ; Majolino, Ignazio ; Bertaina, Alice ; Lucarelli, Barbarella ; Massei, Maria Speranza ; Carotti, Alessandra ; Perruccio, Katia ; Caniglia, Maurizio ; Santarone, Stella ; Di Bartolomeo, Paolo ; Mazzotta, Serena ; Galieni, Piero ; Olivieri, Attilio ; De Rosa, Gennaro ; Risitano, Antonio ; Delia, Mario ; Specchia, Giorgina ; Palazzo, Giulia ; Pisapia, Giovanni ; Messina, Giuseppe ; Irrera, Giuseppe ; Angelucci, Emanuele ; Baronciani, Donatella ; Vacca, Adriana ; Crescimanno, Alessandra ; Musso, Maurizio ; Scimè, Rosanna ; Imbriani, Alida ; Milone, Giuseppe. / Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy. In: Bone Marrow Transplantation. 2014 ; pp. 1-7.

@article{e7da80b9bea4446c88db584867e3a0d4,

title = "Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy",

abstract = "Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.",

keywords = "infection, infection",

author = "Patrizia Chiusolo and Simona Sica and C. Girmenia and Rossolini, {G. M.} and A. Piciocchi and A. Bertaina and G. Pisapia and D. Pastore and A. Severino and L. Cudillo and F. Ciceri and R. Scim{\`e} and L. Lombardini and C. Viscoli and A. Rambaldi and Marco Frigeni and Alessandro Rambaldi and Consuelo Corti and Fabio Ciceri and Gabriella Mometto and Claudio Annaloro and Erminia Casari and Luca Castagna and Giuseppe Rossi and Chiara Cattaneo and Domenico Russo and Valeria Cancelli and Alessandrino, {Emilio Paolo} and Francesco Ripamonti and Fabio Pavan and Attilio Rovelli and Clara Pecoraro and Alessandro Busca and Francesca Carraro and Franca Fagioli and Susanna Gallo and Daniele Caravelli and {De Gobbi}, Marco and Giuseppe Saglio and Claudia Castellino and Nicola Mordini and Gianluca Gaidano and Luca Nassi and Roberto Raimondi and Michele Vespignani and Scattolin, {Anna Maria} and Panizzolo, {Irene Sara} and Simone Cesaro and Anna Candoni and Francesca Patriarca and Andrea Bacigalupo and Annamaria Raiola and Elio Castagnola and Edoardo Lanino and Marta Stanzani and Giuseppe Bandini and Erika Massaccesi and Arcangelo Prete and Simona Bassi and Daniele Vallisa and Cecilia Caramatti and Franco Aversa and Eliana Zuffa and Stefano Guidi and Alberto Bosi and Veronica Tintori and Iori, {Anna Paola} and Saveria Capria and Laura Cudillo and William Arcese and Teresa Dentamaro and {De Fabritiis}, Paolo and Barbara Anaclerico and Anna Chierichini and Monica Piedimonte and Antonella Ferrari and Francesco Marchesi and Andrea Mengarelli and Elisabetta Cerchiara and Tirindelli, {Maria Cristina} and Javid Gaziev and Alessandro Severino and Ignazio Majolino and Alice Bertaina and Barbarella Lucarelli and Massei, {Maria Speranza} and Alessandra Carotti and Katia Perruccio and Maurizio Caniglia and Stella Santarone and {Di Bartolomeo}, Paolo and Serena Mazzotta and Piero Galieni and Attilio Olivieri and {De Rosa}, Gennaro and Antonio Risitano and Mario Delia and Giorgina Specchia and Giulia Palazzo and Giovanni Pisapia and Giuseppe Messina and Giuseppe Irrera and Emanuele Angelucci and Donatella Baronciani and Adriana Vacca and Alessandra Crescimanno and Maurizio Musso and Rosanna Scim{\`e} and Alida Imbriani and Giuseppe Milone",

year = "2014",

doi = "10.1038/bmt.2014.231",

language = "English",

pages = "1--7",

journal = "Bone Marrow Transplantation",

issn = "0268-3369",

publisher = "[London] : Nature Pub. Group Basingstoke : Nature Publishing Group",

}

Chiusolo, P , Sica, S, Girmenia, C, Rossolini, GM, Piciocchi, A, Bertaina, A, Pisapia, G, Pastore, D, Severino, A, Cudillo, L, Ciceri, F, Scimè, R, Lombardini, L, Viscoli, C, Rambaldi, A, Frigeni, M, Rambaldi, A, Corti, C, Ciceri, F, Mometto, G, Annaloro, C, Casari, E, Castagna, L, Rossi, G, Cattaneo, C, Russo, D, Cancelli, V, Alessandrino, EP, Ripamonti, F, Pavan, F, Rovelli, A, Pecoraro, C, Busca, A, Carraro, F, Fagioli, F, Gallo, S, Caravelli, D, De Gobbi, M, Saglio, G, Castellino, C, Mordini, N, Gaidano, G, Nassi, L, Raimondi, R, Vespignani, M, Scattolin, AM, Panizzolo, IS, Cesaro, S, Candoni, A, Patriarca, F, Bacigalupo, A, Raiola, A, Castagnola, E, Lanino, E, Stanzani, M, Bandini, G, Massaccesi, E, Prete, A, Bassi, S, Vallisa, D, Caramatti, C, Aversa, F, Zuffa, E, Guidi, S, Bosi, A, Tintori, V, Iori, AP, Capria, S, Cudillo, L, Arcese, W, Dentamaro, T, De Fabritiis, P, Anaclerico, B, Chierichini, A, Piedimonte, M, Ferrari, A, Marchesi, F, Mengarelli, A, Cerchiara, E, Tirindelli, MC, Gaziev, J, Severino, A, Majolino, I, Bertaina, A, Lucarelli, B, Massei, MS, Carotti, A, Perruccio, K, Caniglia, M, Santarone, S, Di Bartolomeo, P, Mazzotta, S, Galieni, P, Olivieri, A, De Rosa, G, Risitano, A, Delia, M, Specchia, G, Palazzo, G, Pisapia, G, Messina, G, Irrera, G, Angelucci, E, Baronciani, D, Vacca, A, Crescimanno, A, Musso, M, Scimè, R, Imbriani, A & Milone, G 2014, 'Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy', Bone Marrow Transplantation, pp. 1-7. https://doi.org/10.1038/bmt.2014.231

Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy. / Chiusolo, Patrizia ; Sica, Simona; Girmenia, C.; Rossolini, G. M.; Piciocchi, A.; Bertaina, A.; Pisapia, G.; Pastore, D.; Severino, A.; Cudillo, L.; Ciceri, F.; Scimè, R.; Lombardini, L.; Viscoli, C.; Rambaldi, A.; Frigeni, Marco; Rambaldi, Alessandro; Corti, Consuelo; Ciceri, Fabio; Mometto, Gabriella; Annaloro, Claudio; Casari, Erminia; Castagna, Luca; Rossi, Giuseppe; Cattaneo, Chiara; Russo, Domenico; Cancelli, Valeria; Alessandrino, Emilio Paolo; Ripamonti, Francesco; Pavan, Fabio; Rovelli, Attilio; Pecoraro, Clara; Busca, Alessandro; Carraro, Francesca; Fagioli, Franca; Gallo, Susanna; Caravelli, Daniele; De Gobbi, Marco; Saglio, Giuseppe; Castellino, Claudia; Mordini, Nicola; Gaidano, Gianluca; Nassi, Luca; Raimondi, Roberto; Vespignani, Michele; Scattolin, Anna Maria; Panizzolo, Irene Sara; Cesaro, Simone; Candoni, Anna; Patriarca, Francesca; Bacigalupo, Andrea; Raiola, Annamaria; Castagnola, Elio; Lanino, Edoardo; Stanzani, Marta; Bandini, Giuseppe; Massaccesi, Erika; Prete, Arcangelo; Bassi, Simona; Vallisa, Daniele; Caramatti, Cecilia; Aversa, Franco; Zuffa, Eliana; Guidi, Stefano; Bosi, Alberto; Tintori, Veronica; Iori, Anna Paola; Capria, Saveria; Cudillo, Laura; Arcese, William; Dentamaro, Teresa; De Fabritiis, Paolo; Anaclerico, Barbara; Chierichini, Anna; Piedimonte, Monica; Ferrari, Antonella; Marchesi, Francesco; Mengarelli, Andrea; Cerchiara, Elisabetta; Tirindelli, Maria Cristina; Gaziev, Javid; Severino, Alessandro; Majolino, Ignazio; Bertaina, Alice; Lucarelli, Barbarella; Massei, Maria Speranza; Carotti, Alessandra; Perruccio, Katia; Caniglia, Maurizio; Santarone, Stella; Di Bartolomeo, Paolo; Mazzotta, Serena; Galieni, Piero; Olivieri, Attilio; De Rosa, Gennaro; Risitano, Antonio; Delia, Mario; Specchia, Giorgina; Palazzo, Giulia; Pisapia, Giovanni; Messina, Giuseppe; Irrera, Giuseppe; Angelucci, Emanuele; Baronciani, Donatella; Vacca, Adriana; Crescimanno, Alessandra; Musso, Maurizio; Scimè, Rosanna; Imbriani, Alida; Milone, Giuseppe.

In: Bone Marrow Transplantation, 2014, p. 1-7.

Research output: Contribution to journal › Article

TY - JOUR

T1 - Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy

AU - Chiusolo, Patrizia

AU - Sica, Simona

AU - Girmenia, C.

AU - Rossolini, G. M.

AU - Piciocchi, A.

AU - Bertaina, A.

AU - Pisapia, G.

AU - Pastore, D.

AU - Severino, A.

AU - Cudillo, L.

AU - Ciceri, F.

AU - Scimè, R.

AU - Lombardini, L.

AU - Viscoli, C.

AU - Rambaldi, A.

AU - Frigeni, Marco

AU - Rambaldi, Alessandro

AU - Corti, Consuelo

AU - Ciceri, Fabio

AU - Mometto, Gabriella

AU - Annaloro, Claudio

AU - Casari, Erminia

AU - Castagna, Luca

AU - Rossi, Giuseppe

AU - Cattaneo, Chiara

AU - Russo, Domenico

AU - Cancelli, Valeria

AU - Alessandrino, Emilio Paolo

AU - Ripamonti, Francesco

AU - Pavan, Fabio

AU - Rovelli, Attilio

AU - Pecoraro, Clara

AU - Busca, Alessandro

AU - Carraro, Francesca

AU - Fagioli, Franca

AU - Gallo, Susanna

AU - Caravelli, Daniele

AU - De Gobbi, Marco

AU - Saglio, Giuseppe

AU - Castellino, Claudia

AU - Mordini, Nicola

AU - Gaidano, Gianluca

AU - Nassi, Luca

AU - Raimondi, Roberto

AU - Vespignani, Michele

AU - Scattolin, Anna Maria

AU - Panizzolo, Irene Sara

AU - Cesaro, Simone

AU - Candoni, Anna

AU - Patriarca, Francesca

AU - Bacigalupo, Andrea

AU - Raiola, Annamaria

AU - Castagnola, Elio

AU - Lanino, Edoardo

AU - Stanzani, Marta

AU - Bandini, Giuseppe

AU - Massaccesi, Erika

AU - Prete, Arcangelo

AU - Bassi, Simona

AU - Vallisa, Daniele

AU - Caramatti, Cecilia

AU - Aversa, Franco

AU - Zuffa, Eliana

AU - Guidi, Stefano

AU - Bosi, Alberto

AU - Tintori, Veronica

AU - Iori, Anna Paola

AU - Capria, Saveria

AU - Cudillo, Laura

AU - Arcese, William

AU - Dentamaro, Teresa

AU - De Fabritiis, Paolo

AU - Anaclerico, Barbara

AU - Chierichini, Anna

AU - Piedimonte, Monica

AU - Ferrari, Antonella

AU - Marchesi, Francesco

AU - Mengarelli, Andrea

AU - Cerchiara, Elisabetta

AU - Tirindelli, Maria Cristina

AU - Gaziev, Javid

AU - Severino, Alessandro

AU - Majolino, Ignazio

AU - Bertaina, Alice

AU - Lucarelli, Barbarella

AU - Massei, Maria Speranza

AU - Carotti, Alessandra

AU - Perruccio, Katia

AU - Caniglia, Maurizio

AU - Santarone, Stella

AU - Di Bartolomeo, Paolo

AU - Mazzotta, Serena

AU - Galieni, Piero

AU - Olivieri, Attilio

AU - De Rosa, Gennaro

AU - Risitano, Antonio

AU - Delia, Mario

AU - Specchia, Giorgina

AU - Palazzo, Giulia

AU - Pisapia, Giovanni

AU - Messina, Giuseppe

AU - Irrera, Giuseppe

AU - Angelucci, Emanuele

AU - Baronciani, Donatella

AU - Vacca, Adriana

AU - Crescimanno, Alessandra

AU - Musso, Maurizio

AU - Scimè, Rosanna

AU - Imbriani, Alida

AU - Milone, Giuseppe

PY - 2014

Y1 - 2014

N2 - Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

AB - Infections by carbapenem-resistant Klebsiella pneumoniae (CRKp) represent a challenging problem after SCT. A retrospective survey (January 2010 to July 2013) involving 52 Italian centers was performed to assess the epidemiology and the prognostic factors of CRKp infections in auto- and allo-SCT. Cases of CRKp infection were reported in 53.4% of centers. CRKp infections were documented in 25 auto-SCTs and 87 allo-SCTs, with an incidence of 0.4% (from 0.1% in 2010 to 0.7% in 2013) and 2% (from 0.4% in 2010 to 2.9% in 2013), respectively. A CRKp colonization documented before or after transplant was followed by an infection in 25.8% of auto-SCT and 39.2% of allo-SCT patients. The infection-related mortality rates were 16% and 64.4%, respectively. A pre-transplant CRKp infection (hazard ratio (HR) 0.33, 95% confidence intervals (CIs) 0.15-0.74; P=0.007) and a not CRKp-targeted first-line treatment (HR 2.67, 95% CI 1.43-4.99; P=0.002) were independent factors associated with an increased mortality in allo-SCT patients who developed a CRKp infection. Our study shows challenging findings of CRKp infections in SCT patients in Italy particularly after allo-SCT. The detection of carriers and the definition of early therapeutic strategies represent critical aspects of the management of CRKp infections after SCT.

KW - infection

UR - http://hdl.handle.net/10807/62582

U2 - 10.1038/bmt.2014.231

DO - 10.1038/bmt.2014.231

M3 - Article

SP - 1

EP - 7

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

ER -

Infections by carbapenem-resistant Klebsiella pneumoniae in SCT recipients: a nationwide retrospective survey from Italy

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