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Risk Factors for Subsequential Carbapenem-Resistant Klebsiella pneumoniae Clinical Infection Among Rectal Carriers with Carbapenem-Resistant Klebsiella pneumoniae.
Infect Drug Resist. 2020; 13:1299-1305.ID

Abstract

Purpose

Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has become a critical clinical concern for its high mortality. Rectal carriage of CRKP has been reported playing an important role in CRKP infection; however, the extent to which carrier develops clinical CRKP infection is unclear. This study aimed to identify risk factors for developing subsequential CRKP clinical infection in rectal carriers with CRKP.

Patients and Methods

Patients were screened for rectal carriage of CRKP in a tertiary university hospital; then, rectal CRKP carriers were divided into case group (those who developed subsequential clinical infection) and control group. Demographics, comorbid conditions, invasive procedures, antimicrobial exposure and other clinical parameters of those two groups were compared and analyzed using univariate and multivariate logistic regression analyses. Antimicrobial susceptibility profile and carbapenemase phenotype/genotype of those CRKP isolates were determined. MLST was applied to elucidate the molecular epidemiology of rectal CRKP isolates and clinical infection ones.

Results

Eight hundred and thirty-five patients were screened for rectal CRKP carriage. A total of 62 CRKP rectal carriers were identified; among them, 37.1% (23/62) developed CRKP clinical infection. CRKP isolates were resistant to most of the tested antimicrobial agents. ST11 was the dominant MLST type in rectal CRKP isolates (71.0%), and all the 23 clinical infection isolates were ST11. Multivariate analysis revealed that admission to the intensive care unit (ICU) (OR, 6.753; P=0.006), being in coma condition (OR, 11.085; P=0.015) and receiving central venous catheter (OR, 8.628; P=0.003) were independent risk factors for progressing to subsequential CRKP infection among those rectal carriers.

Conclusion

This study identified independent risk factors for developing subsequential CRKP clinical infection among CRKP rectal carriers, with being in coma condition as a new finding. It would help clinician target those high-risk rectal CRKP-colonized patients for prevention of subsequential clinical infection.

Authors+Show Affiliations

Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.Department of Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, Hunan, People's Republic of China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32440167

Citation

Chen, Xia, et al. "Risk Factors for Subsequential Carbapenem-Resistant Klebsiella Pneumoniae Clinical Infection Among Rectal Carriers With Carbapenem-Resistant Klebsiella Pneumoniae." Infection and Drug Resistance, vol. 13, 2020, pp. 1299-1305.
Chen X, Liu Q, Liu WE, et al. Risk Factors for Subsequential Carbapenem-Resistant Klebsiella pneumoniae Clinical Infection Among Rectal Carriers with Carbapenem-Resistant Klebsiella pneumoniae. Infect Drug Resist. 2020;13:1299-1305.
Chen, X., Liu, Q., Liu, W. E., & Yan, Q. (2020). Risk Factors for Subsequential Carbapenem-Resistant Klebsiella pneumoniae Clinical Infection Among Rectal Carriers with Carbapenem-Resistant Klebsiella pneumoniae. Infection and Drug Resistance, 13, 1299-1305. https://doi.org/10.2147/IDR.S247101
Chen X, et al. Risk Factors for Subsequential Carbapenem-Resistant Klebsiella Pneumoniae Clinical Infection Among Rectal Carriers With Carbapenem-Resistant Klebsiella Pneumoniae. Infect Drug Resist. 2020;13:1299-1305. PubMed PMID: 32440167.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk Factors for Subsequential Carbapenem-Resistant Klebsiella pneumoniae Clinical Infection Among Rectal Carriers with Carbapenem-Resistant Klebsiella pneumoniae. AU - Chen,Xia, AU - Liu,Qingnuan, AU - Liu,Wen-En, AU - Yan,Qun, Y1 - 2020/05/05/ PY - 2020/01/23/received PY - 2020/04/16/accepted PY - 2020/5/23/entrez PY - 2020/5/23/pubmed PY - 2020/5/23/medline KW - carbapenem-resistant Klebsiella pneumoniae KW - infection KW - rectal carriage KW - risk factors SP - 1299 EP - 1305 JF - Infection and drug resistance JO - Infect Drug Resist VL - 13 N2 - Purpose: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has become a critical clinical concern for its high mortality. Rectal carriage of CRKP has been reported playing an important role in CRKP infection; however, the extent to which carrier develops clinical CRKP infection is unclear. This study aimed to identify risk factors for developing subsequential CRKP clinical infection in rectal carriers with CRKP. Patients and Methods: Patients were screened for rectal carriage of CRKP in a tertiary university hospital; then, rectal CRKP carriers were divided into case group (those who developed subsequential clinical infection) and control group. Demographics, comorbid conditions, invasive procedures, antimicrobial exposure and other clinical parameters of those two groups were compared and analyzed using univariate and multivariate logistic regression analyses. Antimicrobial susceptibility profile and carbapenemase phenotype/genotype of those CRKP isolates were determined. MLST was applied to elucidate the molecular epidemiology of rectal CRKP isolates and clinical infection ones. Results: Eight hundred and thirty-five patients were screened for rectal CRKP carriage. A total of 62 CRKP rectal carriers were identified; among them, 37.1% (23/62) developed CRKP clinical infection. CRKP isolates were resistant to most of the tested antimicrobial agents. ST11 was the dominant MLST type in rectal CRKP isolates (71.0%), and all the 23 clinical infection isolates were ST11. Multivariate analysis revealed that admission to the intensive care unit (ICU) (OR, 6.753; P=0.006), being in coma condition (OR, 11.085; P=0.015) and receiving central venous catheter (OR, 8.628; P=0.003) were independent risk factors for progressing to subsequential CRKP infection among those rectal carriers. Conclusion: This study identified independent risk factors for developing subsequential CRKP clinical infection among CRKP rectal carriers, with being in coma condition as a new finding. It would help clinician target those high-risk rectal CRKP-colonized patients for prevention of subsequential clinical infection. SN - 1178-6973 UR - https://www.unboundmedicine.com/medline/citation/32440167/Risk_Factors_for_Subsequential_Carbapenem_Resistant_Klebsiella_pneumoniae_Clinical_Infection_Among_Rectal_Carriers_with_Carbapenem_Resistant_Klebsiella_pneumoniae_ L2 - https://dx.doi.org/10.2147/IDR.S247101 DB - PRIME DP - Unbound Medicine ER -
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