High mortality from carbapenem-resistant Klebsiella pneumoniae bloodstream infection

In this study, it was evaluated clinical data of 107 patients with bloodstream infection (BSI) by Klebsiella pneumoniae and performed phenotypic and molecular analyzes in 50.5% (54/107) of the samples, those that showed a resistance profile to carbapenemics. The bla KPC gene was present in 90.4% (49/54) of the samples, bla NDM gene in one sample and, in 7.4% (4/54) of the samples, no carbapenemase gene was found. In the similarity analysis, it was found 4 main clones and 11 samples were not genetically related. The median age of the patients was 58 (40–70) years old and 60.7% (65/107) were male. When comparing two groups of patients with BSI due to K. pneumoniae with and without resistance to carbapenems, the variables ICU permanence, renal failure (IR), previous use of antimicrobials, Charlson's comorbidity index (ICCi), some invasive procedures and death showed a statistically significant difference (p < 0.05). And when relating death as a dependent variable, IR, liver failure and patients with BSI XDR or PDR, were predictors of increased mortality. Our study showed a higher mortality rate in patients with BSI due to carbapenem-resistant pneumonia with additional resistance or not to polymyxins. • Carbapenemases producing Klebsiella pneumoniae and high mortality rates related to healthcare-related infections. • Bloodstream infection caused by K. pneumoniae is due to complex clinical conditions complicated by multiple previous comorbidities and invasive hospital procedures. • KPC is the most frequent mechanism found in carbapenem-resistant K. pneumoniae isolates from bloodstream infections.