{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:28:16Z","timestamp":1785421696698,"version":"3.56.0"},"reference-count":17,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100006280","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 111-2314-B-A49-044"],"award-info":[{"award-number":["MOST 111-2314-B-A49-044"]}],"id":[{"id":"10.13039\/501100006280","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006280","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["NSTC 112-2314-B-A49-029 and NSTC 114-2314-B-A49-079-MY3"],"award-info":[{"award-number":["NSTC 112-2314-B-A49-029 and NSTC 114-2314-B-A49-079-MY3"]}],"id":[{"id":"10.13039\/501100006280","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Taipei Veterans General Hospital-National Yang-Ming University Excellent Physician Scientists Cultivation Program","award":["106-V-B-027"],"award-info":[{"award-number":["106-V-B-027"]}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V114C-047"],"award-info":[{"award-number":["V114C-047"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Szu-Yuan Research Foundation of Internal Medicine"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2025,12,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Hypervirulent\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      (hvKp) can cause serious community-acquired pyogenic infections and is prevalent in Asian countries. Unlike classical\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      , which is usually multidrug resistant, hvKp is usually antimicrobial-sensitive. However, the optimal definitive treatment for hvKp bacteremia remains unclear, with carbapenems often used due to severe conditions. We aimed to compare clinical outcomes of patients with hvKp bacteremia treated with carbapenems and non-carbapenems in Taiwan. This retrospective study included patients with monomicrobial hvKp bacteremia treated with appropriate definitive therapy at Taipei Veterans General Hospital from January 2015 to December 2017.\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      isolates carrying\n                      <jats:italic toggle=\"yes\">rmpA<\/jats:italic>\n                      \/\n                      <jats:italic toggle=\"yes\">rmpA2<\/jats:italic>\n                      genes were defined as hypervirulent strains. A multivariate logistic regression model and propensity score-matched analyses were used to identify independent risk factors for 28-day mortality. A total of 236 patients with hvKp bacteremia were identified, and 52 patients received carbapenems. The non-carbapenem group had a lower 28-day mortality than that in the carbapenem group (10.3% versus 23.1%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016). Multivariate analysis showed definitive carbapenem therapy was not associated with 28-day mortality (OR, 1.39; 95% CI, 0.47\u20134.10;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.549). Among 90 patients with an Acute Physiology and Chronic Health Evaluation (APACHE) II score \u226515, definitive therapy with carbapenems was still not associated with 28-day mortality (OR, 2.63; 95% CI, 0.58 to 12.00;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.212). The propensity score-matched analyses yielded similar results. In conclusion, definitive carbapenem therapy for hvKp bacteremia was not associated with a survival benefit compared with non-carbapenem therapy, even in critically ill patients. The study provides valuable insights into antimicrobial stewardship in endemic regions of hvKp.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00846-25","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T13:00:36Z","timestamp":1763470836000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Carbapenems versus non-carbapenems as definitive treatment for hypervirulent\n                    <i>Klebsiella pneumoniae<\/i>\n                    bacteremia in Taiwan"],"prefix":"10.1128","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5130-4619","authenticated-orcid":false,"given":"Chih-Han","family":"Juan","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03ymy8z76","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Department of Medicine, Taipei Veterans General 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