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Gastrointestinal Carriage Is a Major Reservoir of Klebsiella pneumoniae Infection in Intensive Care Patients

Claire L. Gorrie, Mirjana Mirčeta, Ryan R. Wick and 11 more

Clinical Infectious Diseases · 2017 · CC BY

Abstract

Background.. Klebsiella pneumoniae is an opportunistic pathogen and leading cause of hospital-associated infections. Intensive care unit (ICU) patients are particularly at risk. Klebsiella pneumoniae is part of the healthy human microbiome, providing a potential reservoir for infection. However, the frequency of gut colonization and its contribution to infections are not well characterized.

Methods.. We conducted a 1-year prospective cohort study in which 498 ICU patients were screened for rectal and throat carriage of K. pneumoniae shortly after admission. Klebsiella pneumoniae isolated from screening swabs and clinical diagnostic samples were characterized using whole genome sequencing and combined with epidemiological data to identify likely transmission events.

Results.. Klebsiella pneumoniae carriage frequencies were estimated at 6% (95% confidence interval [CI], 3%–8%) among ICU patients admitted direct from the community, and 19% (95% CI, 14%–51%) among those with recent healthcare contact. Gut colonization on admission was significantly associated with subsequent infection (infection risk 16% vs 3%, odds ratio [OR] = 6.9, P <.001), and genome data indicated matching carriage and infection isolates in 80% of isolate pairs. Five likely transmission chains were identified, responsible for 12% of K. pneumoniae infections in ICU. In sum, 49% of K. pneumoniae infections were caused by the patients’ own unique strain, and 48% of screened patients with infections were positive for prior colonization.

Conclusions.. These data confirm K. pneumoniae colonization is a significant risk factor for infection in ICU, and indicate ~50% of K. pneumoniae infections result from patients’ own microbiota. Screening for colonization on admission could limit risk of infection in the colonized patient and others.

References 35

1.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
2.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
3.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
4.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
5.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
6.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
7.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
8.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
9.
FastTree 2 – Approximately Maximum-Likelihood Trees for Large Alignments · 2010
No notice
10.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
11.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
12.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
13.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
14.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
15.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
16.
Species-Level Analysis of DNA Sequence Data from the NIH Human Microbiome Project · 2012
No notice
17.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
18.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
19.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
20.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
21.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
22.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
23.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
24.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
25.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
26.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
27.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
28.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
29.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
30.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
31.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
32.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
33.
This reference’s wording can’t be shown under the paper’s licence.
Not in our library
34.
Molecular Epidemiology of Colonizing and Infecting Isolates of Klebsiella pneumoniae · 2016
No notice
35.
Genome-scale rates of evolutionary change in bacteria · 2016
No notice

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