Cano, AngelaGutierrez-Gutierrez, BelenMachuca, IsabelTorre-Gimenez, JulianGracia-Ahufinger, IreneNatera, Alejandra MPerez-Nadales, ElenaCaston, Juan JoseRodriguez-Baño, JesusMartinez-Martinez, LuisTorre-Cisneros, Julian2023-05-032023-05-032022-03-03Cano 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):e0197021http://hdl.handle.net/10668/20042Colonization 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.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Carbapenemase-producing Klebsiella pneumoniaeRisk of infectionTiming of colonizationAnti-bacterial agentsBacterial proteinsHumansKlebsiella infectionsKlebsiella pneumoniaeLongitudinal studiesProspective studiesbeta-Lactamasesresearch article35323035open accessAntibacterianosEstudios longitudinalesEstudios prospectivosInfecciones por KlebsiellaKlebsiella pneumoniaeProteínas bacterianas10.1128/spectrum.01970-212165-0497PMC9045231https://digital.csic.es/bitstream/10261/296556/1/Klebsiella-pneumoniae.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9045231/pdf