{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:28:10Z","timestamp":1791336490279,"version":"4.3.1"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","issue":"12","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":1858,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:sec id=\"S0195941700038029_abs1\"><jats:title>Background.<\/jats:title><jats:p><jats:italic>Klebsiella pneumoniae<\/jats:italic> carbapenemase (KPC)-producing <jats:italic>K. pneumoniae<\/jats:italic> is an emerging pathogen with serious clinical and infection control implications. To our knowledge, no study has specifically examined risk factors for KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> or its impact on mortality.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038029_abs2\"><jats:title>Methods.<\/jats:title><jats:p>To identify risk factors for infection or colonization with KPC-producing <jats:italic>K. pneumoniae<\/jats:italic>, a case-control study was performed. Case patients with KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> were compared with control subjects with carbapenem-susceptible <jats:italic>K. pneumoniae<\/jats:italic>. A cohort study evaluated the association between KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> and in-hospital mortality.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038029_abs3\"><jats:title>Results.<\/jats:title><jats:p>Fifty-six case patients and 863 control subjects were identified. In multivariable analysis, independent risk factors for KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> were (1) severe illness (adjusted odds ratio [AOR], 4.31; 95% confidence interval [CI], 2.25\u20138.25), (2) prior fluoroquinolone use (AOR, 3.39; 95% CI, 1.50, 7.66), and (3) prior extended-spectrum cephalosporin use (AOR, 2.55; 95% CI, 1.18, 5.52). Compared with samples from other anatomic locations, <jats:italic>K. pneumoniae<\/jats:italic> isolates from blood samples were less likely to harbor KPC (AOR, 0.33; 95% CI, 0.12, 0.86). KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> was independently associated with in-hospital mortality (AOR, 3.60; 95% CI, 1.87\u20136.91).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700038029_abs4\"><jats:title>Conclusions.<\/jats:title><jats:p>KPC-producing <jats:italic>K. pneumoniae<\/jats:italic> is an emerging pathogen associated with significant mortality. Our findings highlight the urgent need to develop strategies for prevention and infection control. Limiting use of certain antimicrobials, specifically fluoroquinolones and cephalosporins, use may be effective strategies.<\/jats:p><\/jats:sec>","DOI":"10.1086\/648451","type":"journal-article","created":{"date-parts":[[2009,10,27]],"date-time":"2009-10-27T17:05:27Z","timestamp":1256663127000},"page":"1180-1185","source":"Crossref","is-referenced-by-count":277,"title":["Risk Factors and Clinical Impact of <i>Klebsiella pneumoniae<\/i> Carbapenemase-Producing <i>K. pneumoniae<\/i>"],"prefix":"10.1017","volume":"30","author":[{"given":"Leanne B.","family":"Gasink","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul H.","family":"Edelstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebbing","family":"Lautenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Synnestvedt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil O.","family":"Fishman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700038029_ref029","doi-asserted-by":"publisher","DOI":"10.1086\/502365"},{"key":"S0195941700038029_ref006","doi-asserted-by":"publisher","DOI":"10.1086\/421495"},{"key":"S0195941700038029_ref016","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2005.11.165"},{"key":"S0195941700038029_ref008","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.7.3018-3020.2005"},{"key":"S0195941700038029_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2006.12.012"},{"key":"S0195941700038029_ref014","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01020-07"},{"key":"S0195941700038029_ref002","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2003.12.019"},{"key":"S0195941700038029_ref033","doi-asserted-by":"publisher","DOI":"10.1086\/428052"},{"key":"S0195941700038029_ref027","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01451-07"},{"key":"S0195941700038029_ref013","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.12.1430"},{"key":"S0195941700038029_ref034","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.12.4793-4799.2004"},{"key":"S0195941700038029_ref007","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00299-07"},{"key":"S0195941700038029_ref011","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl541"},{"key":"S0195941700038029_ref026","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00493-08"},{"key":"S0195941700038029_ref024","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01185-07"},{"key":"S0195941700038029_ref001","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.7.885"},{"key":"S0195941700038029_ref031","doi-asserted-by":"publisher","DOI":"10.1086\/507274"},{"key":"S0195941700038029_ref030","doi-asserted-by":"publisher","DOI":"10.1001\/jama.281.6.517"},{"key":"S0195941700038029_ref023","unstructured":"3M Health Information Systems. All-patient refined diagnosis related groups (APR-DRGs) methodology overview, version 20. Wallingford, CT:3M Health Information Systems; 2003."},{"key":"S0195941700038029_ref009","doi-asserted-by":"publisher","DOI":"10.3201\/eid1210.060297"},{"key":"S0195941700038029_ref035","doi-asserted-by":"publisher","DOI":"10.1086\/520214"},{"key":"S0195941700038029_ref015","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm356"},{"key":"S0195941700038029_ref017","doi-asserted-by":"publisher","DOI":"10.1086\/592412"},{"key":"S0195941700038029_ref018","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02143-08"},{"key":"S0195941700038029_ref022","doi-asserted-by":"publisher","DOI":"10.1086\/520740"},{"key":"S0195941700038029_ref025","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00158-08"},{"key":"S0195941700038029_ref005","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)62567-6"},{"key":"S0195941700038029_ref028","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2004.09.015"},{"key":"S0195941700038029_ref032","doi-asserted-by":"publisher","DOI":"10.1086\/381550"},{"key":"S0195941700038029_ref021","doi-asserted-by":"publisher","DOI":"10.1086\/319600"},{"key":"S0195941700038029_ref004","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2004.10.001"},{"key":"S0195941700038029_ref012","doi-asserted-by":"publisher","DOI":"10.3201\/eid1208.060291"},{"key":"S0195941700038029_ref020","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00015-07"},{"key":"S0195941700038029_ref010","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00186-06"},{"key":"S0195941700038029_ref019","doi-asserted-by":"publisher","DOI":"10.1086\/505598"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0195941700038029","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T02:38:38Z","timestamp":1556591918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0195941700038029\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":35,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["S0195941700038029"],"URL":"https:\/\/doi.org\/10.1086\/648451","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]}}}