a7b9944ca0ddf0923df744f75795cf15 pmc_9495006.pdf ebb262f1edb6a2a016b4b4e14b432b2cc97815c9 pmc_9495006.pdf 7b3f3f4f16b195328fed5e67f452abde3753b29de2ce1e993b058c783b2fdd4b pmc_9495006.pdf Title: Current Positioning against Severe Infections Due to Klebsiella pneumoniae in Hospitalized Adults Subject: Infections due to Klebsiella pneumoniae have been increasing in intensive care units (ICUs) in the last decade. Such infections pose a serious problem, especially when antimicrobial resistance is present. We created a task force of experts, including specialists in intensive care medicine, anaesthesia, microbiology and infectious diseases, selected on the basis of their varied experience in the field of nosocomial infections, who conducted a comprehensive review of the recently published literature on the management of carbapenemase-producing Enterobacterales (CPE) infections in the intensive care setting from 2012 to 2022 to summarize the best available treatment. The group established priorities regarding management, based on both the risk of developing infections caused by K. pneumoniae and the risk of poor outcome. Moreover, we reviewed and updated the most important clinical entities and the new antibiotic treatments recently developed. After analysis of the priorities outlined, this group of experts established a series of recommendations and designed a management algorithm. Keywords: carbapenemase-producing Enterobacterales (CPE); Klebsiella pneumoniae; KPC; VAP; nosocomial pneumonia; ceftazidime-avibactam; imipenem-relebactam; meropenem-vaborbactam; cefiderocol; ICU Author: Pablo Vidal-Cortés, Ignacio Martin-Loeches, Alejandro Rodríguez, Germán Bou, Rafael Cantón, Emili Diaz, Carmen De la Fuente, Julián Torre-Cisneros, Francisco Xavier Nuvials, Miguel Salavert, Gerardo Aguilar, Mercedes Nieto, Paula Ramírez, Marcio Borges, Cruz Soriano, Ricard Ferrer, Emilio Maseda and Rafael Zaragoza Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Aug 27 13:13:42 2022 CEST ModDate: Sat Aug 27 13:43:02 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1357433 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MKLNPG+VnURWPalladioL Type 1 Custom yes yes no 10 0 XBJTJJ+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 CKOXDP+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 QXZJLT+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 NCECFU+URWPalladioL-BoldItal Type 1 Custom yes yes no 28 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 YYFPCJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 73 0 OYLTVA+CMSY10 Type 1 Builtin yes yes no 83 0 NJPGIH+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 108 0 NJPGII+PalatinoLinotype CID TrueType Identity-H yes yes yes 111 0 NJPGIJ+PalatinoLinotype TrueType WinAnsi yes yes no 117 0 NJPGIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 120 0 NJPHOF+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 123 0 NJPGIH+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 138 0 NJPGII+PalatinoLinotype CID TrueType Identity-H yes yes yes 141 0 NJPGIJ+PalatinoLinotype TrueType WinAnsi yes yes no 147 0 NJPGIL+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 150 0 NOCJIL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 160 0 NOCJIN+PalatinoLinotype TrueType WinAnsi yes yes no 163 0 NOCJIP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 166 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-16 03:11:27 CEST RepresentationInformation: pmc_9495006.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-16 02:36:34 CEST Size: 1357433 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 552 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Current Epidemiology, Pathogeny and Antimicrobial Resistance of Klebsiella pneumoniae Infections in the ICU Destination: section.2 Item: Title: Klebsiella pneumoniae in ICUs: Risk Factors and Outcome Destination: section.3 Children: Item: Title: Updated Risk Factors Destination: subsection.3.1 Item: Title: Prognostic Factors Destination: subsection.3.2 Item: Title: Clinical Entities Destination: section.4 Children: Item: Title: Pneumonia Destination: subsection.4.1 Children: Item: Title: Community-Acquired Pneumonia (CAP) Destination: subsubsection.4.1.1 Item: Title: Nosocomial Pneumonia Destination: subsubsection.4.1.2 Item: Title: Outcome Destination: subsubsection.4.1.3 Item: Title: Bacteremia Destination: subsection.4.2 Item: Title: Urinary Tract Infection (UTI) Destination: subsection.4.3 Item: Title: Intra-Abdominal Infections Destination: subsection.4.4 Item: Title: Central Nervous System (CNS) Infections Destination: subsection.4.5 Item: Title: The Role of Hypervirulent Klebsiella pneumoniae Destination: subsection.4.6 Item: Title: Clinical Management of Infections Caused by CR-Kp Destination: section.5 Children: Item: Title: General Issues: Monotherapy or Combination Therapy? Destination: subsection.5.1 Item: Title: How Should CR-Kp Sensitive to Meropenem Be Treated? Destination: subsection.5.2 Item: Title: How Should a CR-Kp Resistant to Meropenem Be Treated? Destination: subsection.5.3 Item: Title: Materials and Methods Destination: section.6 Item: Title: References Destination: section.6 Info: Title: Current Positioning against Severe Infections Due to Klebsiella pneumoniae in Hospitalized Adults Author: Pablo Vidal-Cortés, Ignacio Martin-Loeches, Alejandro Rodríguez, Germán Bou, Rafael Cantón, Emili Diaz, Carmen De la Fuente, Julián Torre-Cisneros, Francisco Xavier Nuvials, Miguel Salavert, Gerardo Aguilar, Mercedes Nieto, Paula Ramírez, Marcio Borges, Cruz Soriano, Ricard Ferrer, Emilio Maseda and Rafael Zaragoza Subject: Infections due to Klebsiella pneumoniae have been increasing in intensive care units (ICUs) in the last decade. Such infections pose a serious problem, especially when antimicrobial resistance is present. We created a task force of experts, including specialists in intensive care medicine, anaesthesia, microbiology and infectious diseases, selected on the basis of their varied experience in the field of nosocomial infections, who conducted a comprehensive review of the recently published literature on the management of carbapenemase-producing Enterobacterales (CPE) infections in the intensive care setting from 2012 to 2022 to summarize the best available treatment. The group established priorities regarding management, based on both the risk of developing infections caused by K. pneumoniae and the risk of poor outcome. Moreover, we reviewed and updated the most important clinical entities and the new antibiotic treatments recently developed. After analysis of the priorities outlined, this group of experts established a series of recommendations and designed a management algorithm. Keywords: carbapenemase-producing Enterobacterales (CPE); Klebsiella pneumoniae; KPC; VAP; nosocomial pneumonia; ceftazidime-avibactam; imipenem-relebactam; meropenem-vaborbactam; cefiderocol; ICU Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Aug 27 13:13:42 CEST 2022 ModDate: Sat Aug 27 13:43:02 CEST 2022 ID: 0x2d5b93367db36d1f2cd55618903e2db5, 0x2d5b93367db36d1f2cd55618903e2db5 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: JYPLJJ+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 226 FontDescriptor: FontName: JYPLJJ+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: OYLTVA+CMSY10 FontSubset: true FirstChar: 0 LastChar: 48 FontDescriptor: FontName: OYLTVA+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: CKOXDP+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: 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