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Antimicrobial resistance and virulence factors of Klebsiella pneumoniae affecting 30 day mortality in patients with bloodstream infection

DC FieldValueLanguage
dc.contributor.author김도균-
dc.contributor.author이혁민-
dc.contributor.author정석훈-
dc.contributor.author이혁민-
dc.contributor.author정석훈-
dc.date.accessioned2019-02-14T01:57:20Z-
dc.date.available2019-02-14T01:57:20Z-
dc.date.issued2019-
dc.identifier.issn0305-7453-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/167313-
dc.description.abstractObjectives: To investigate the risk factors of patients with Klebsiella pneumoniae (KP) bloodstream infection (BSI) with a focus on antimicrobial resistance and virulence factors. Methods: All KP BSI patients (n = 579) from six general hospitals during a 1 year period were included in this study. The risk factors of hosts and causative KP isolates were assessed to determine associations with the 30 day mortality of KP BSI patients by multivariate Cox hazards modelling. Results: The 30 day mortality rate of KP BSI patients was 16.9% (98/579). Among the host-associated factors, increased SOFA score and leucopenia status exhibited strong associations with increased 30 day mortality. Among the pathogenic factors, carriage of the pks gene cluster (adjusted HR 1.80; 95% CI 1.16-2.79) was a risk factor, especially when accompanied by MDR. In this regard, KP isolates of the wzi50 capsular type (n = 22) frequently harboured pks (63.6%, 14/22) and ybtA (68.2%, n = 15) and mostly exhibited MDR (63.6%, n = 14), resulting in increased 30 day mortality. In contrast, hypermucoviscous KP isolates showed an inverse association with 30 day mortality (adjusted HR 0.55; 95% CI 0.33-0.90). Conclusions: Despite the reported virulence of hypermucoviscous KP strains, they were associated with good prognoses in KP BSI patients. Importantly, carriage of the pks gene cluster, which is responsible for the synthesis of colibactin, was a relevant marker of early mortality.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherOxford University Press-
dc.relation.isPartOfJOURNAL OF ANTIMICROBIAL CHEMOTHERAPY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleAntimicrobial resistance and virulence factors of Klebsiella pneumoniae affecting 30 day mortality in patients with bloodstream infection-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Laboratory Medicine (진단검사의학교실)-
dc.contributor.googleauthorDokyun Kim-
dc.contributor.googleauthorByeol Yi Park-
dc.contributor.googleauthorMin Hyuk Choi-
dc.contributor.googleauthorEun-Jeong Yoon-
dc.contributor.googleauthorHyukmin Lee-
dc.contributor.googleauthorKwang Jun Lee-
dc.contributor.googleauthorYoon Soo Park-
dc.contributor.googleauthorJong Hee Shin-
dc.contributor.googleauthorYoung Uh-
dc.contributor.googleauthorKyeong Seob Shin-
dc.contributor.googleauthorJeong Hwan Shin-
dc.contributor.googleauthorYoung Ah Kim-
dc.contributor.googleauthorSeok Hoon Jeong-
dc.identifier.doi10.1093/jac/dky397-
dc.contributor.localIdA04891-
dc.contributor.localIdA03286-
dc.contributor.localIdA03286-
dc.contributor.localIdA03619-
dc.contributor.localIdA03619-
dc.contributor.localIdA03286-
dc.contributor.localIdA03286-
dc.contributor.localIdA03619-
dc.contributor.localIdA03619-
dc.relation.journalcodeJ01237-
dc.identifier.eissn1460-2091-
dc.identifier.pmid30295771-
dc.identifier.urlhttps://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dky397-
dc.contributor.alternativeNameKim, Dokyun-
dc.contributor.affiliatedAuthor김도균-
dc.contributor.affiliatedAuthor이혁민-
dc.contributor.affiliatedAuthor이혁민-
dc.contributor.affiliatedAuthor정석훈-
dc.contributor.affiliatedAuthor정석훈-
dc.contributor.affiliatedAuthor이혁민-
dc.contributor.affiliatedAuthor이혁민-
dc.contributor.affiliatedAuthor정석훈-
dc.contributor.affiliatedAuthor정석훈-
dc.citation.volume74-
dc.citation.number1-
dc.citation.startPage190-
dc.citation.endPage199-
dc.identifier.bibliographicCitationJOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol.74(1) : 190-199, 2019-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers

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