Details

Autor(en) / Beteiligte

• Cano, Ángela
• Gutiérrez-Gutiérrez, Belén
• Machuca, Isabel
• Torre-Giménez, Julián
• Frutos-Adame, Azahara
• García-Gutiérrez, Manuel
• Gallo-Marín, Marina
• Gracia-Ahufinger, Irene
• Artacho, María J.
• Natera, Alejandra M.
• Pérez-Nadales, Elena
• Castón, Juan José
• Mameli, Sabrina
• Gómez-Delgado, Francisco
• de la Fuente, Carmen
• Salcedo, Inmaculada
• Rodríguez-Baño, Jesús
• Martínez-Martínez, Luis
• Torre-Cisneros, Julián

Titel

Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study

Ist Teil von

• Journal of global antimicrobial resistance., 2022-06, Vol.29, p.476-482

Ort / Verlag

Elsevier Ltd

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Regarding the association of KPC-producing Klebsiella pneumoniae (KPC-Kp) rectal colonisation with crude mortality:•Colonisation does not increase crude mortality per se.•Colonisation was a necessary although insufficient cause of KPC-Kp infection.•Risk of mortality in colonised patients depends on development of severe KPC-Kp infection. 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.