%0 Journal Article
%A Cano, Angela
%A Gutierrez-Gutierrez, Belen
%A Machuca, Isabel
%A Torre-Gimenez, Julian
%A Frutos-Adame, Azahara
%A Garcia-Gutierrez, Manuel
%A Gallo-Marin, Marina
%A Gracia-Ahufinger, Irene
%A Artacho, María J
%A Natera, Alejandra M
%A Perez-Nadales, Elena
%A Caston, Juan Jose
%A Mameli, Sabrina
%A Gomez-Delgado, Francisco
%A de la Fuente, Carmen
%A Salcedo, Inmaculada
%A Rodriguez-Baño, Jesus
%A Martinez-Martinez, Luis
%A Torre-Cisneros, Julian
%T Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study.
%D 2021
%U http://hdl.handle.net/10668/22307
%X We evaluated the association of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) rectal colonisation with crude mortality and whether this association is independent of the risk of KPC-Kp infection. This was a prospective cohort study of patients followed-up 90 days after a study of rectal colonisation. Cox regression was used to study the variables associated with crude mortality. Sensitivity analyses for 90-day crude mortality in different subcohorts were performed. A total of 1244 patients (1078 non-colonised and 166 colonised) were included. None of the non-colonised patients and 78 (47.0%) of the colonised patients developed KPC-Kp infection. The 90-day crude mortality was 18.0% (194/1078) in non-colonised patients and 41.6% (69/166) in colonised patients. Rectal colonisation was not associated with crude mortality [hazard ratio (HR) = 1.03, 95% confidence interval (CI) 0.69-1.54; P = 0.85] when the model was adjusted for severe KPC-Kp infection [INCREMENT-CPE score (ICS) > 7]. KPC-Kp infection with ICS > 7 was associated with an increased risk of all-cause mortality (HR = 2.21, 95% CI 1.35-3.63; P = 0.002). In the sensitivity analyses, KPC-Kp colonisation was not associated with mortality in any of the analysed subcohorts, including patients who did not develop KPC-Kp infection (HR = 0.93, 95% CI 0.60-1.43; P = 0.74). KPC-Kp rectal colonisation was not associated with crude mortality. Mortality increased when colonised patients developed severe KPC-Kp infection (ICS > 7). Rectal colonisation was a necessary although insufficient condition to die from a KPC-Kp infection.
%K Carbapenemase-producing Klebsiella pneumoniae
%K Colonisation
%K KPC
%K Mortality
%K Severe infection
%~