Cano, AngelaGutierrez-Gutierrez, BelenMachuca, IsabelTorre-Gimenez, JulianFrutos-Adame, AzaharaGarcia-Gutierrez, ManuelGallo-Marin, MarinaGracia-Ahufinger, IreneArtacho, María JNatera, Alejandra MPerez-Nadales, ElenaCaston, Juan JoseMameli, SabrinaGomez-Delgado, Franciscode la Fuente, CarmenSalcedo, InmaculadaRodriguez-Baño, JesusMartinez-Martinez, LuisTorre-Cisneros, Julian2023-05-032023-05-032021-10-24Cano Á, Gutiérrez-Gutiérrez B, Machuca I, Torre-Giménez J, Frutos-Adame A, García-Gutiérrez M, et al. Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study. J Glob Antimicrob Resist. 2022 Jun;29:476-482http://hdl.handle.net/10668/22307We 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.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/Carbapenemase-producing Klebsiella pneumoniaeColonisationKPCMortalitySevere infectionBacterial proteinsHumansKlebsiellaKlebsiella infectionsKlebsiella pneumoniaeProspective studiesRetrospective studiesBeta-lactamasesresearch article34788693open accessEstudios prospectivosEstudios retrospectivosInfecciones por KlebsiellaKlebsiellaKlebsiella pneumoniaeProteínas bacterianas10.1016/j.jgar.2021.10.0242213-7173https://doi.org/10.1016/j.jgar.2021.10.024