Dataset Information

Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study.

ABSTRACT:

Introduction

The objective of this study was to examine the evolution of carbapenem-resistant Klebsiella pneumoniae (CRKp) infections and their impact at a tertiary care hospital in South India.

Methods

A comparative analysis of clinical data from two prospective cohorts of patients with CRKp bacteremia (C1, 2014-2015; C2, 2021-2022) was carried out. Antimicrobial susceptibilities and whole genome sequencing (WGS) data of selected isolates were also analyzed.

Results

A total of 181 patients were enrolled in the study, 56 from C1 and 125 from C2. CRKp bacteremia shifted from critically ill patients with neutropenia to others (ICU stay: C1, 73%; C2, 54%; p = 0.02). The overall mortality rate was 50% and the introduction of ceftazidime-avibactam did not change mortality significantly (54% versus 48%; p = 0.49). Oxacillinases (OXA) 232 and 181 were the most common mechanisms of resistance. WGS showed the introduction of New Delhi metallo-β-lactamase-5 (NDM-5), higher genetic diversity, accessory genome content, and plasmid burden, as well as increased convergence of hypervirulence and carbapenem resistance in C2.

Conclusions

CRKp continues to pose a significant clinical threat, despite the introduction of new antibiotics. The study highlights the evolution of resistance and virulence in this pathogen and the impact on patient outcomes in South India, providing valuable information for clinicians and researchers.

SUBMITTER: Manesh A

PROVIDER: S-EPMC10229510 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Publications

Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study.

Manesh Abi A Shankar Chaitra C George Mithun M MM Jasrotia Davinder S DS Lal Binesh B George Biju B Mathews Vikram V Eapen C E CE Joseph Philip P Subramani K K Rao Shoma S Peter John V JV Chacko Binila B Zachariah Anand A Sathyendra Sowmya S Hansdak Samuel G SG Abraham Ooriapadickal C OC Iyadurai Ramya R Vijayakumar Saranya S Karthik Rajiv R Marwick Charis A CA Parcell Benjamin J BJ Gilbert Ian H IH Veeraraghavan Balaji B Varghese George M GM

Infectious diseases and therapy 20230416 5

<h4>Introduction</h4>The objective of this study was to examine the evolution of carbapenem-resistant Klebsiella pneumoniae (CRKp) infections and their impact at a tertiary care hospital in South India.<h4>Methods</h4>A comparative analysis of clinical data from two prospective cohorts of patients with CRKp bacteremia (C1, 2014-2015; C2, 2021-2022) was carried out. Antimicrobial susceptibilities and whole genome sequencing (WGS) data of selected isolates were also analyzed.<h4>Results</h4>A tota ...[more]

PMID: 37062023

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Dataset Information

Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study.

Introduction

Methods

Results

Conclusions

Publications

Clinical and Genomic Evolution of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infections over Two Time Periods at a Tertiary Care Hospital in South India: A Prospective Cohort Study.

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