RT Journal Article
T1 Association between Timing of Colonization and Risk of Developing Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae Infection in Hospitalized Patients.
A1 Cano, Angela
A1 Gutierrez-Gutierrez, Belen
A1 Machuca, Isabel
A1 Torre-Gimenez, Julian
A1 Gracia-Ahufinger, Irene
A1 Natera, Alejandra M
A1 Perez-Nadales, Elena
A1 Caston, Juan Jose
A1 Rodriguez-Baño, Jesus
A1 Martinez-Martinez, Luis
A1 Torre-Cisneros, Julian
K1 Carbapenemase-producing Klebsiella pneumoniae
K1 Risk of infection
K1 Timing of colonization
AB Colonization by KPC-producing Klebsiella pneumoniae (KPC-Kp) is associated with the risk of developing KPC-Kp infection. The impact of the time elapsed since a patient becomes colonized on this risk is not well known. An observational, prospective, longitudinal cohort study of colonized patients undergoing active rectal culture screening to rule out KPC-Kp colonization (July 2012 to November 2017). Patients with a positive culture at inclusion (colonized at start of follow-up) and those with a negative culture at inclusion who became colonized within 90 days (colonized during follow-up) were included in the analysis. CART analysis was used to dichotomize variables according to their association with infection. Kaplan-Meier infection-free survival curves and the log-rank test were used for group comparisons. Logistic regression was used to identify variables associated with KPC-Kp infection. Among 1310 patients included, 166 were colonized at the end of follow-up. Forty-seven out of 118 patients colonized at start of follow-up developed infection (39.8%) versus 31 out of 48 patients colonized during follow-up (64.6%; P = 0.006). Variables associated with KPC-Kp infection in the logistic regression analysis were: colonization detection during follow-up (OR, 2.74; 95% CI, 1.07 to 7.04; P = 0.03), Giannella risk score (OR, 1.51; 95% CI, 1.32 to 1.73; P,0.001), high-risk ward (OR, 4.77; 95% CI, 1.61 to 14.10; P = 0.005) and urological manipulation after admission (OR, 3.69; 95% CI, 1.08 to 12.60; P = 0.04). In 25 out of 31 patients (80.6%) colonized during follow-up who developed KPC-Kp infection, infection appeared within 15 days after colonization. The risk of KPC-Kp infection was higher when colonization is recently acquired during hospitalization. In this prospective study, we concluded that the timing of colonization was a factor to assess when considering empirical treatment for suspected KPC-Kp infection and prophylaxis or infection control.
PB American Society for Microbiology
YR 2022
FD 2022-03-03
LK http://hdl.handle.net/10668/20042
UL http://hdl.handle.net/10668/20042
LA en
NO Cano Á, Gutiérrez-Gutiérrez B, Machuca I, Torre-Giménez J, Gracia-Ahufinger I, Natera AM, et al.  Association between Timing of Colonization and Risk of Developing Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae Infection in Hospitalized Patients. Microbiol Spectr. 2022 Apr 27;10(2):e0197021
NO This work was supported by the Spanish National R&D&I Plan 2013 to 2016 and theCarlos III Health Institute, Sub-Directorate General for Cooperative Research Centers and Networks, Ministry of Economy, Industry, and Competitiveness, Spanish Network for Research in Infectious Diseases (REIPI RD16/0016/0001; RD16/0016/0008) and cofinanced by the European Development Regional Fund “A Way to Achieve Europe,” Operative Program Smart Growth 2014 to 2020. B.G.G. has a contract to intensify
DS RISalud
RD Apr 10, 2025