A systematic review of the association between delayed appropriate therapy and mortality among patients hospitalized with infections due to Klebsiella pneumoniae or Escherichia coli: how long is too long?

Lodise, Thomas P.; Zhao, Qi; Fahrbach, Kyle; Gillard, Patrick J.; Martin, Amber

doi:10.1186/s12879-018-3524-8

Table 1 Studies Reporting Overall Mortality Data for Delayed Appropriate Therapy of Infections Due to Klebsiella pneumoniae or Escherichia coli

From: A systematic review of the association between delayed appropriate therapy and mortality among patients hospitalized with infections due to Klebsiella pneumoniae or Escherichia coli: how long is too long?

Author, Year	Time Point for DAT, h	Pathogen	Resistance Status	Therapy Type	Infection Type	n/N	Mortality Rate, %
Abhilash et al., 2010 [12]	48	K. pneumoniae or E. coli	73.3% ESBL producing	Appropriate	Bacteremia; primary sources: UTI, intra-abdominal, pneumonia	17/74	23.0
Abhilash et al., 2010 [12]	48	K. pneumoniae or E. coli	73.3% ESBL producing	DAT		16/57	28.1
Anderson et al., 2006 [13]	72	K. pneumoniae	7.7% CAZ-R (of which 85% ESBL producers)	Appropriate	Bacteremia	12/38	31.6
Anderson et al., 2006 [13]	72	K. pneumoniae	7.7% CAZ-R (of which 85% ESBL producers)	DAT	Bacteremia	14/22	63.6
Daikos et al., 2009 [11]	NR	K. pneumoniae	41.4% VPKP (of which 20.9% CRE)	Appropriate	Bacteremia	23/137	16.8
Daikos et al., 2009 [11]	NR	K. pneumoniae	41.4% VPKP (of which 20.9% CRE)	DAT	Bacteremia	8/25	32.0
Du et al., 2002 [14]	NR	K. pneumoniae or E. coli	27% ESBL producers	Appropriate	Bacteremia	14/71	19.7
Du et al., 2002 [14]	NR	K. pneumoniae or E. coli	27% ESBL producers	DAT	Bacteremia	7/14	50.0
Gransden et al., 1990 [15]	48	E. coli	NR	Appropriate	Bacteremia; primary source: UTI, other^a	109/659	16.5
Gransden et al., 1990 [15]	48	E. coli	NR	DAT	Bacteremia; primary source: UTI, other^a	36/132	27.3
Jung et al., 2012 [16]	NR	K. pneumoniae	3.3% ESBL producers	Appropriate	Bacteremia; primary source: UTI, other^b	82/500	16.4
Jung et al., 2012 [16]	NR	K. pneumoniae	3.3% ESBL producers	DAT	Bacteremia; primary source: UTI, other^b	15/54	27.8
Kang et al., 2004 [17]	24	K. pneumoniae	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: pancreatobiliary tract, liver, pneumonia, UTI, peritonitis	7/33	21.2
	24	K. pneumoniae		DAT		3/14	21.4
	24	E. coli		Appropriate		2/25	8.0
	24	E. coli		DAT		4/23	17.4
Kang et al., 2013 [18]	72	E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: bacteremia, UTI, biliary tract, intra-abdominal, pneumonia	3/28	10.7
Kang et al., 2013 [18]	72	E. coli	100% ESBL producers (study-selected)	DAT		7/64	10.9
Kim et al., 2002 [19]	72	K. pneumoniae	27.2% ESBL producers	Appropriate	Bacteremia; primary source: bacteremia, biliary, pneumonia, UTI, liver, peritonitis	5/19	26.3
Kim et al., 2002 [19]	72	K. pneumoniae	27.2% ESBL producers	DAT		5/24	20.8
Lee et al., 2012 [30]	NR	K. pneumoniae or E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: pneumonia, urosepsis, other^c	25/230	10.9
Lee et al., 2012 [30]	NR	K. pneumoniae or E. coli	100% ESBL producers (study-selected)	DAT	Bacteremia; primary source: pneumonia, urosepsis, other^c	8/21	38.1
Metan et al., 2005 [20]	NR	E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: pneumonia, UTI, pancreaticobiliary tract, post-surgical wound, cellulitis, abdominal abscess	12/45	26.7
Metan et al., 2005 [20]	NR	E. coli	100% ESBL producers (study-selected)	DAT		2/8	25.0
Micek et al., 2010 [21]	24	E. coli	3% ESBL producers	Appropriate	Bacteremia; primary source: lungs, UTI, central venous catheter, intra-abdominal	60/188	31.9
	24	E. coli	3% ESBL producers	DAT		11/37	29.7
	24	K. pneumoniae	8.5% ESBL producers	Appropriate		47/129	36.4
	24	K. pneumoniae	8.5% ESBL producers	DAT		15/30	50.0
Ortega et al., 2011 [22]	NR	K. pneumoniae	12% CTX-R	Appropriate	Bacteremia; primary source: UTI, biliary, catheter-related, pneumonia, abdomen, skin and soft tissue	82/824	10.0
Ortega et al., 2011 [22]	NR	K. pneumoniae		DAT		14/86	16.3
Park et al., 2011 [23]	24	E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: UTI, intra-abdominal; hepatobiliary; skin and soft tissue	10/108	9.3
Park et al., 2011 [23]	24	E. coli	100% ESBL producers (study-selected)	DAT		7/42	16.7
Rodriguez-Bano et al., 2010 [24]	24	E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: UTI, intra-abdominal, respiratory tract	16/53	30.2
Rodriguez-Bano et al., 2010 [24]	24	E. coli	100% ESBL producers (study-selected)	DAT		13/43	30.2
Schiappa et al., 1996 [25]	72	K. pneumoniae or E. coli	100% CAZ-R (study-selected)	Appropriate	Bacteremia	1/19	5.3
Schiappa et al., 1996 [25]	72	K. pneumoniae or E. coli	100% CAZ-R (study-selected)	DAT	Bacteremia	5/12	41.7
Tuon et al., 2011 [26]	48	K. pneumoniae	60% ESBL producers	Appropriate	Bacteremia	28/55	50.9
Tuon et al., 2011 [26]	48	K. pneumoniae	60% ESBL producers	DAT	Bacteremia	20/49	40.8
Wang et al., 2011 [27]	NR	K. pneumoniae or E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: pneumonia, urosepsis, intra-abdominal, bacteremia, vascular catheter-related, skin and soft tissue	12/50	24.0
Wang et al., 2011 [27]	NR	K. pneumoniae or E. coli	100% ESBL producers (study-selected)	DAT		15/63	23.8
Wu et al., 2012 [28]	48	E. coli	100% ESBL producers (study-selected)	Appropriate	Bacteremia; primary source: urinary tract, intra-abdominal, bacteremia	4/24	16.7
Wu et al., 2012 [28]	48	E. coli	100% ESBL producers (study-selected)	DAT		9/38	23.4
Zarkotou et al., 2011 [29]	24	K. pneumonia	100% KPC producers (study-selected)	Appropriate	Bacteremia; primary source: central venous catheter, respiratory tract, UTI, skin or soft tissue, central nervous system	5/14	35.7
Zarkotou et al., 2011 [29]	24	K. pneumonia	100% KPC producers (study-selected)	DAT		13/39	33.3

CAZ-R ceftazidime-resistant, CRE carbapenem-resistant Enterobacteriaceae, CTX-R cefotaxime resistant, DAT delayed appropriate therapy, E. coli Escherichia coli, ESBL extended-spectrum beta lactamase, KPC K. pneumoniae carbapenemase, K. pneumoniae Klebsiella pneumoniae, NR not reported, UTI urinary tract infection, VPKP VIM-1-producing K. pneumoniae
^aBiliary tract, intestine, genital tract, bone/joint, meninges, respiratory tract, endocardium, skin/soft tissue, wound
^bPeritoneum, pancreatobiliary tract, liver, lung, skin and soft tissue, bone, central nervous system
^cVascular catheter-related infection, intra-abdominal, bacteremia, skin and soft tissue

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