dc.creator | Pérez Nadales, Elena | es |
dc.creator | Natera, Alejandra M. | es |
dc.creator | Recio Rufián, Manuel | es |
dc.creator | Guzmán Puche, Julia | es |
dc.creator | Cano, Ángela | es |
dc.creator | Frutos Adame, Azahara | es |
dc.creator | Castón, Juan José | es |
dc.creator | Elías-López, Cristina | es |
dc.creator | López Cerero, Lorena | es |
dc.creator | Torre-Cisneros, Julian | es |
dc.date.accessioned | 2022-10-19T14:32:13Z | |
dc.date.available | 2022-10-19T14:32:13Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | Pérez Nadales, E., Natera, A.M., Recio Rufián, M., Guzmán Puche, J., Cano, Á., Frutos Adame, A.,...,Torre-Cisneros, J. (2022). Proof‑of‑concept study to quantify changes in intestinal loads of KPC-producing Klebsiella pneumoniae in colonised patients following selective digestive decontamination with oral gentamicin. Journal of Global Antimicrobial Resistance, 30, 16-22. https://doi.org/10.1016/j.jgar.2022.04.010. | |
dc.identifier.issn | 2213-7173 | es |
dc.identifier.uri | https://hdl.handle.net/11441/138121 | |
dc.description.abstract | Objectives
To monitor quantitatively the extent of intestinal colonisation by KPC-producing Klebsiella pneumoniae (KPC-Kp) in colonised patients who receive selective digestive decontamination (SDD) with oral gentamicin.
Methods
We developed a real-time quantitative PCR (qPCR) method for determination of the relative load of blaKPC (RLKPC) within the gut microbiota. Clinical validation was performed using a culture method as the gold standard and receiver operating curve (ROC) analysis. Fifteen patients were observationally and prospectively followed for one year. Clinical, microbiological variables and rectal swab samples were collected at 0 (baseline), 14 and 30 days and monthly thereafter.
Results
Clinical validation performed on 111 rectal swab samples demonstrated that the PCR method detected 17% more positives than the culture method. ROC curve analysis documented excellent agreement between both methods (area under the curve, 0.96; 95% confidence interval 0.93–0.99). The RLKPC decreased in 6/15 (40%) and 7/12 (58.3%) patients on days 14 and 30, respectively. Persistent eradication was observed in 2/12 (16.7%), 3/9 (33.3%), 4/8 (50%) and 7/8 (87.5%) patients at 1, 3, 6 and 12 months, respectively, with a median time of 150 days (range 30–270) to persistent eradication. Gentamicin-resistant KPC-Kp isolates were identified in 4/15 (26.7%) patients. The rates of infections (57.1% vs. 12.5%, P = 0.119) and deaths (71.4% vs. 0%, P = 0.007) were higher among patients with high baseline RLKPC.
Conclusion
Following SDD, a rapid reduction on intestinal load is observed when the colonising KPC-Kp isolate is susceptible to gentamicin; however, persistent eradication at the end of SDD is low. Intestinal carriage of KPC-Kp persists after three months in about one third of patients. | es |
dc.description.sponsorship | Agencia Española de Investigación and Fondo Europeo de Desarrollo Regional (FEDER) FIS PI16/01631 | es |
dc.description.sponsorship | Ministerio de Ciencia, Innovación y Universidades RD16/0016/0008 | es |
dc.format | application/pdf | es |
dc.format.extent | 7 p. | es |
dc.language.iso | eng | es |
dc.publisher | Elsevier | es |
dc.relation.ispartof | Journal of Global Antimicrobial Resistance, 30, 16-22. | |
dc.rights | Atribución 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject | Intestinal colonisation | es |
dc.subject | Selective digestive decontamination | es |
dc.subject | Antimicrobial resistance | es |
dc.subject | KPC-producing Klebsiella pneumoniae | es |
dc.subject | Bacterial load | es |
dc.title | Proof‑of‑concept study to quantify changes in intestinal loads of KPC-producing Klebsiella pneumoniae in colonised patients following selective digestive decontamination with oral gentamicin | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Microbiología | es |
dc.relation.projectID | FIS PI16/01631 | es |
dc.relation.projectID | RD16/0016/0008 | es |
dc.relation.publisherversion | https://dx.doi.org/10.1016/j.jgar.2022.04.010 | es |
dc.identifier.doi | 10.1016/j.jgar.2022.04.010 | es |
dc.journaltitle | Journal of Global Antimicrobial Resistance | es |
dc.publication.volumen | 30 | es |
dc.publication.initialPage | 16 | es |
dc.publication.endPage | 22 | es |
dc.contributor.funder | Agencia Estatal de Investigación. España | es |
dc.contributor.funder | European Commission (EC). Fondo Europeo de Desarrollo Regional (FEDER) | es |
dc.contributor.funder | Ministerio de Ciencia, Innovación y Universidades (MICINN). España | es |