In this study, the authors retrospectively evaluated clinical outcomes of 75 patients from a New Delhi hospital with dual colistin- and carbapenem-resistant Klebsiella pneumoniae bloodstream infections over a 5-year period in a single tertiary care hospital in India. They observed a high in-hospital mortality rate of 69.3%. Risk factors significantly associated with increased mortality included ICU stay at the time of BSI (61% vs 88.5%, P = .006), length of stay prior to the onset of BSI (mean days ± SD, 10.1 ± 9.4 vs 19.3 ± 20; P = .03), Pitt bacteremia score ≥4 (21.7% vs 84.6%, P < .001), and pneumonia as source of BSI (4.3% vs 26.9%, P = .03).
The high mortality in these patients is a concern. Limitations of this study include its retrospective nature and the failure to identify molecular mechanisms of colistin and carbapenem resistance.