Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Oct;53(5):1737-1744.
doi: 10.1007/s15010-025-02488-x. Epub 2025 Mar 7.

Clinical outcomes of patients hospitalized in internal medicine wards adequately treated for bloodstream infections caused by NDM-producing Klebsiella pneumoniae. Results from a real-life retrospective multi-center study in an endemic area

Simone Meini  1 , Roberta Del Cesta  2 , Francesco Sbrana  3 , Javier Rosada  4 , Davide Carrara  5 , Maddalena Mura  2 , Benedetta Longo  2 , Roberto Andreini  2 , Giuseppe Linsalata  4 , Alessandro Fedele  4 , Francesco Filidei  5 , Andrea Ripoli  3 , Elisabetta Andreoli  6 , Enrico Tagliaferri  7 , Spartaco Sani  7
Affiliations
Multicenter Study

Clinical outcomes of patients hospitalized in internal medicine wards adequately treated for bloodstream infections caused by NDM-producing Klebsiella pneumoniae. Results from a real-life retrospective multi-center study in an endemic area

Simone Meini et al. Infection. 2025 Oct.

Erratum in

Abstract

Background: New Delhi metallo-beta-lactamase (NDM)-producing Klebsiella pneumoniae (NDM-Kp) represents a growing challenge for modern medicine.

Objectives: To assess real-life clinical outcomes in patients adequately treated in Internal medicine units (IMUs) for bloodstream infections (BSI) caused by NDM-Kp.

Methods: A two-years retrospective study was conducted recruiting 30 consecutive adult patients with NDM-Kp BSI treated with an adequate definitive antibiotic therapy (27 aztreonam plus ceftazidime/avibactam; 3 cefiderocol) in three Italian IMUs located in a highly endemic area.

Results: Mean age of patients was 75.3 years, mean Charlson Comorbidity Index (CCI) 7.5. All the patients had rectal colonization. Thirty-day mortality rate was 46.7%; 78.6% of patients who died received an adequate empiric therapy. Non-survivors had mean age, CCI and SOFA score significantly higher compared to survivors (80.1 vs. 71.2, p = 0.036; 8.6 vs. 6.6, p = 0.047; 5.9 vs. 4, p = 0.043, respectively). The percentage of survivors was significantly higher among the 13 cases with community-acquired than in the 17 with hospital-acquired BSI (76.9% vs. 35.3%, p = 0.024). In the multivariate penalized logistic regression analysis, age, CCI, SOFA score and hospital-acquired BSI onset were identified as independent predictors of mortality.

Conclusion: This study provides real-life data on clinical outcomes regarding old and highly multimorbid patients hospitalized in IMU for BSI caused by NDM-Kp, showing a very high 30-day mortality even in case of adequate treatment.

Keywords: Klebsiella pneumoniae producing New Delhi metallo-beta-lactamase; Elderly; Internal medicine; Outcomes.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

References

    1. Yong D, Toleman MA, Giske CG, et al. Characterization of a new metallo-beta-lactamase gene, bla (NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009;53(12):5046–54. - DOI - PubMed - PMC
    1. Wu W, Feng Y, Tang G, et al. NDM Metallo-β-Lactamases and their bacterial producers in Health Care settings. Clin Microbiol Rev. 2019;30(322):e00115–18.
    1. Farhat N, Khan AU. Evolving trends of New Delhi Metallo-Betalactamse (NDM) variants: a threat to antimicrobial resistance. Infect Genet Evol. 2020;86:104588. - DOI - PubMed
    1. Khan AU, Maryam L, Zarrilli R. Structure genetics and worldwide spread of New Delhi Metallo-β-lactamase (NDM): a threat to public health. BMC Microbiol. 2017;27;17(1):101.
    1. Tavoschi L, Forni S, Porretta A, On Behalf Of The Tuscan Clinical Microbiology Laboratory Network, et al. Prolonged outbreak of New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE), Tuscany, Italy, 2018 to 2019. Euro Surveill. 2020;25(6):2000085. - DOI - PubMed - PMC

Publication types

MeSH terms

LinkOut - more resources