Risk factors associated with carbapenemase-producing Klebsiella pneumoniae fecal carriage: A case-control study in a Spanish tertiary care hospital.
Asymptomatic colonization of the gastrointestinal tract by carbapenemase-producing Enterobacteriaceae is an important reservoir for transmission that may precede infection. This prospective, observational, case-control study was designed to identify risk factors for carbapenemase-producing Klebsiella pneumoniae (CPKP) fecal carriage. This study included 87 cases and 200 controls. Multivariate analysis identified length of stay (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.01-1.03; P = .03), previous hospitalization (OR, 5.89; 95% CI, 1.73-20.68; P = .01), antibiotic use (OR, 0.20; 95% CI, 0.65-0.62; P = .01), and corticosteroid use (OR, 0.33; 95% CI, 0.15-0.74; P = .007) as independent risk factors for CPKP rectal carriage. Length of hospital stay, previous hospitalization, corticosteroid use, and antimicrobial exposure are important risk factors for CPKP rectal colonization. Adherence to infection control practices and directed surveillance programs appear to be critical components for CPKP control programs.
Departamento de Microbiología y Medicina Preventiva, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain. Electronic address: ana_madueno@hotmail.com.
Ana
A
Madueño
Departmento de Farmacia, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
Jonathan
J
González García
Departamento de Microbiología y Medicina Preventiva, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
Maria José
MJ
Ramos
Departamento de Microbiología y Medicina Preventiva, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
Yanet
Y
Pedroso
Departamento de Microbiología y Medicina Preventiva, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain.
Zaida
Z
Díaz
Laboratorio de Referencia e Investigación en Resistencia a Antibióticos e Infecciones Relacionadas con la Asistencia Sanitaria, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.
Jesus
J
Oteo
Departamento de Microbiología y Medicina Preventiva, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain; Departamento de Medicina Preventiva y Salud Pública, Universidad de la Laguna, La Laguna, Santa Cruz de Tenerife, Spain.
María
M
Lecuona
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000378:metabolism*; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D016022:Case-Control Studies; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000379:methods; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain; D062606:Tertiary Care Centers; D055815:Young Adult; D001618:beta-Lactamases / Q000378:metabolism*
D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
Colonization; OXA-48