KPC-producing Klebsiella pneumoniae rectal colonization is a risk factor for mortality in patients with diabetic foot infections.
To evaluate the relationship between carbapenemase-producing Klebsiella pneumoniae (KPC-Kp) gut colonization and mortality in diabetic patients with a foot infection (DFI) we performed a single-centre, retrospective, matched case-control study. In the study period, we identified 21 patients with DFI who had KPC-Kp gut colonization and 21 controls. The 90-day mortality rate was significantly higher in patients with colonized guts (47%) than the controls (4%) (p 0.013). A multivariate analysis demonstrated that gut colonization with KPC-Kp was the only independent predictor of mortality: odds ratio 13.33, 95% CI 1.90-272.80, p 0.024. In patients with DFI, KPC-Kp gut colonization appears to be an important risk factor for mortality.
Infectious Diseases Unit, Cisanello Hospital, Pisa, Italy.
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Tascini
Division of Medical Sciences (Infectious Diseases), University of Oxford, Oxford, UK; Department of Medicine (Infectious Diseases), University of Geneva, Geneva, Switzerland.
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Lipsky
Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy.
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Iacopi
Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
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Ripoli
Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
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Sbrana
Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy.
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Coppelli
Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy.
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Goretti
Diabetic Foot Section, Department of Medicine, University of Pisa, Pisa, Italy.
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Piaggesi
Infectious Diseases Unit, Cisanello Hospital, Pisa, Italy. Electronic address: menichettifrancesco@gmail.com.
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Menichetti
D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D016022:Case-Control Studies; D017719:Diabetic Foot / Q000401:mortality*; D005260:Female; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000302:isolation & purification; D008297:Male; D012307:Risk Factors; D016019:Survival Analysis; D001618:beta-Lactamases / Q000378:metabolism*
D001618:beta-Lactamases
Carbapenem resistant; Diabetic foot infections; KPC-Klebsiella pneumoniae; gut colonization; mortality