Tags

Type your tag names separated by a space and hit enter

The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection.
J Med Microbiol 2019; 68(3):326-335JM

Abstract

PURPOSE

To highlight the clinical significance of carbapenem-resistant Klebsiella pneumoniae (CRKP) rectal colonization by examining the risk factors for CRKP rectal colonization and subsequent bloodstream infection (BSI) in critically ill patients.

METHODOLOGY

Prospective study of CRKP rectal colonization in an intensive care unit (ICU) during a 39-month period. CRKP strains isolated from both the blood cultures and corresponding rectal specimens (n=96) of patients were screened by PCR for the presence of antibiotic resistance-associated genes. Molecular analyses were conducted to investigate the clonal relatedness of CRKP strains from the rectal and blood specimens.

RESULTS

Among the 498 patients, 226 were rectally colonized by CRKP, 48 of whom developed a CRKP BSI. The median time from hospital admission to the detection of CRKP rectal colonization was 8 days, while the median time from colonization to BSI was 4 days. The duration of ICU stay, patient/nurse ratio and prior use of antianaerobic antimicrobials were associated with CRKP rectal colonization. No specific factor was associated with BSIs in the colonized patients. The blaKPC-2 gene was detected in all 96 strains, which were all classified as sequence type ST-258. Representative pairs (n=48) of CRKP strains colonizing and infecting the same patient shared the same pulsotype.

CONCLUSION

Our results indicate that hospitalized patients become infected with their colonizing strains, supporting the strong association between colonization and BSI. Limiting antianaerobic antimicrobial administration, reducing the duration of ICU stay and maintaining a low patient/nurse ratio are possible strategies to restrict rectal CRKP colonization in ICUs.

Authors+Show Affiliations

1 Department of Microbiology, G.Gennimatas General Hospital, Thessaloniki, Greece.2 3rd Department of Pediatrics, Hippokration Hospital, Aristotle University, Thessaloniki, Greece.3 ICU, G. Gennimatas General Hospital, Thessaloniki, Greece.3 ICU, G. Gennimatas General Hospital, Thessaloniki, Greece.4 Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece.4 Department of Microbiology, Medical School, University of Thessaly, Larissa, Greece.5 1st Internal Medicine Department, Infectious Diseases Division, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Greece.6 Department of Microbiology, National School of Public Health, Greece.7 Department of Microbiology, Aristotle University of Thessaloniki Medical School, Thessaloniki, Greece.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30688629

Citation

Kontopoulou, Konstantina, et al. "The Clinical Significance of Carbapenem-resistant Klebsiella Pneumoniae Rectal Colonization in Critically Ill Patients: From Colonization to Bloodstream Infection." Journal of Medical Microbiology, vol. 68, no. 3, 2019, pp. 326-335.
Kontopoulou K, Iosifidis E, Antoniadou E, et al. The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection. J Med Microbiol. 2019;68(3):326-335.
Kontopoulou, K., Iosifidis, E., Antoniadou, E., Tasioudis, P., Petinaki, E., Malli, E., ... Malisiovas, N. (2019). The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection. Journal of Medical Microbiology, 68(3), pp. 326-335. doi:10.1099/jmm.0.000921.
Kontopoulou K, et al. The Clinical Significance of Carbapenem-resistant Klebsiella Pneumoniae Rectal Colonization in Critically Ill Patients: From Colonization to Bloodstream Infection. J Med Microbiol. 2019;68(3):326-335. PubMed PMID: 30688629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection. AU - Kontopoulou,Konstantina, AU - Iosifidis,Elias, AU - Antoniadou,Eleni, AU - Tasioudis,Polychronis, AU - Petinaki,Efthymia, AU - Malli,Ergina, AU - Metallidis,Symeon, AU - Vatopoulos,Alkiviadis, AU - Malisiovas,Nicolaos, Y1 - 2019/01/30/ PY - 2019/1/29/pubmed PY - 2019/3/20/medline PY - 2019/1/29/entrez KW - Carbapenem-resistant Klebsiella pneumoniae KW - bloodstream infections KW - colonization KW - intensive care unit KW - risk factors SP - 326 EP - 335 JF - Journal of medical microbiology JO - J. Med. Microbiol. VL - 68 IS - 3 N2 - PURPOSE: To highlight the clinical significance of carbapenem-resistant Klebsiella pneumoniae (CRKP) rectal colonization by examining the risk factors for CRKP rectal colonization and subsequent bloodstream infection (BSI) in critically ill patients. METHODOLOGY: Prospective study of CRKP rectal colonization in an intensive care unit (ICU) during a 39-month period. CRKP strains isolated from both the blood cultures and corresponding rectal specimens (n=96) of patients were screened by PCR for the presence of antibiotic resistance-associated genes. Molecular analyses were conducted to investigate the clonal relatedness of CRKP strains from the rectal and blood specimens. RESULTS: Among the 498 patients, 226 were rectally colonized by CRKP, 48 of whom developed a CRKP BSI. The median time from hospital admission to the detection of CRKP rectal colonization was 8 days, while the median time from colonization to BSI was 4 days. The duration of ICU stay, patient/nurse ratio and prior use of antianaerobic antimicrobials were associated with CRKP rectal colonization. No specific factor was associated with BSIs in the colonized patients. The blaKPC-2 gene was detected in all 96 strains, which were all classified as sequence type ST-258. Representative pairs (n=48) of CRKP strains colonizing and infecting the same patient shared the same pulsotype. CONCLUSION: Our results indicate that hospitalized patients become infected with their colonizing strains, supporting the strong association between colonization and BSI. Limiting antianaerobic antimicrobial administration, reducing the duration of ICU stay and maintaining a low patient/nurse ratio are possible strategies to restrict rectal CRKP colonization in ICUs. SN - 1473-5644 UR - https://www.unboundmedicine.com/medline/citation/30688629/The_clinical_significance_of_carbapenem_resistant_Klebsiella_pneumoniae_rectal_colonization_in_critically_ill_patients:_from_colonization_to_bloodstream_infection_ L2 - http://jmm.microbiologyresearch.org/pubmed/content/journal/jmm/10.1099/jmm.0.000921 DB - PRIME DP - Unbound Medicine ER -