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Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study
dc.creator | Cano, Ángela | es |
dc.creator | Gutiérrez Gutiérrez, Belén | es |
dc.creator | Machuca, Isabel | es |
dc.creator | Torre-Giménez, Julián | es |
dc.creator | Frutos Adame, Azahara | es |
dc.creator | García Gutiérrez, Manuel | es |
dc.creator | Rodríguez-Baño, Jesús | es |
dc.creator | Torre-Cisneros, Julián | es |
dc.date.accessioned | 2022-11-18T16:55:58Z | |
dc.date.available | 2022-11-18T16:55:58Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | 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. | |
dc.identifier.issn | 2213-7165 | es |
dc.identifier.issn | 2213-7173 | es |
dc.identifier.uri | https://hdl.handle.net/11441/139608 | |
dc.description.abstract | 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. | es |
dc.description.sponsorship | Instituto Carlos III P18/01849 | 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, 29, 476-482. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Carbapenemase-producing Klebsiella pneumoniae | es |
dc.subject | KPC | es |
dc.subject | Colonisation | es |
dc.subject | Mortality | es |
dc.subject | Severe infection | es |
dc.title | Association between rectal colonisation by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae and mortality: a prospective, observational study | es |
dc.type | info:eu-repo/semantics/article | es |
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 Cirugía | es |
dc.relation.publisherversion | http://doi.org/10.1016/j.jgar.2021.10.024 | es |
dc.identifier.doi | 10.1016/j.jgar.2021.10.024 | es |
dc.journaltitle | Journal of Global Antimicrobial Resistance | es |
dc.publication.volumen | 29 | es |
dc.publication.initialPage | 476 | es |
dc.publication.endPage | 482 | es |