Mortality due to KPC carbapenemase-producing Klebsiella pneumoniae infections: Systematic review and meta-analysis

•KPC-KP infection is highly lethal, with a mortality rate in the order of 40%.•Mortality is observed to be variable, depending on the country and hospital ward in which patients are located.•KPC-KP infection-related mortality has been rising in recent years. KPC carbapenemase-producing Klebsiella pn...

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Bibliographic Details
Published in:The Journal of infection 2018-05, Vol.76 (5), p.438-448
Main Authors: Ramos-Castañeda, Jorge A., Ruano-Ravina, Alberto, Barbosa-Lorenzo, Raquel, Paillier-Gonzalez, Jaime E., Saldaña-Campos, Javier C., Salinas, Diego F., Lemos-Luengas, Elkin V.
Format: Article
Language:English
Subjects:
Bacterial resistance
Carbapenemase
Klebsiella pneumoniae
KPC
Mortality
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Summary:•KPC-KP infection is highly lethal, with a mortality rate in the order of 40%.•Mortality is observed to be variable, depending on the country and hospital ward in which patients are located.•KPC-KP infection-related mortality has been rising in recent years. KPC carbapenemase-producing Klebsiella pneumoniae (KPC-KP) has become a major public health challenge. Accordingly, this study sought to use a systematic review of the scientific literature to ascertain the mortality of KPC-KP infection, and analyze such mortality by country, year of publication, hospital ward, and type of interpretation used to define carbapenem resistance. A search without language restrictions was made of the MEDLINE, CENTRAL, EBSCO, LILACS and EMBASE databases from 1996 through June 2017, to locate all studies which had determined the existence of KPC-KP infection. We then performed a meta-analysis of all studies that reported KPC-KP infection-related mortality, and analyzed mortality by subgroup in accordance with standard methodology. A total of 51 papers were included in the systematic review. From 2005 through 2017, data on KPC-KP infection were reported in 5124 patients, with an average of 465 patients per year. The most widely studied type of infection was bacteremia (28∙0%). The meta-analysis showed that overall mortality for the 37 studies was 41.0% (95%CI 37.0–44.0), with the highest mortality rates being observed in oncology patients, 56.0% (95%CI 38.1–73.0), and Brazil, 51.3% (95%CI 43.0–60.0). KPC-KP infection-related mortality is high, is manifested differently in some countries, and is highest among oncology patients.
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2018.02.007