Artículo
Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study
Autor/es | Cano, Ángela
Gutiérrez Gutiérrez, Belén Machuca, Isabel Torre-Giménez, Julián Frutos Adame, Azahara García Gutiérrez, Manuel Rodríguez-Baño, Jesús Torre-Cisneros, Julián |
Departamento | Universidad de Sevilla. Departamento de Cirugía |
Fecha de publicación | 2022 |
Fecha de depósito | 2022-11-18 |
Publicado en |
|
Resumen | Objectives
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 ... Objectives 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. Methods 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. Results 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). Conclusion 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. |
Cita | Cano, Á., Gutiérrez Gutiérrez, B., Machuca, I., Torre-Giménez, J., Frutos Adame, A., García Gutiérrez, M.,...,Torre-Cisneros, J. (2022). Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study. Journal of Global Antimicrobial Resistance, 29, 476-482. https://doi.org/10.1016/j.jgar.2021.10.024. |