The Gastrointestinal Load of Carbapenem-Resistant Enterobacteriacea Is Associated With the Transition From Colonization to Infection by Klebsiella pneumoniae Isolates Harboring the bla KPC Gene.
| Autor: | Migliorini LB; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Leaden L; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., de Sales RO; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Correa NP; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Marins MM; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Koga PCM; Laboratório Clínico, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Toniolo ADR; Serviço de Controle de Infecção Hospitalar, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., de Menezes FG; Serviço de Controle de Infecção Hospitalar, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Martino MDV; Laboratório Clínico, Hospital Israelita Albert Einstein, Sao Paulo, Brazil., Mingorance J; Servicio de Microbiología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain., Severino P; Albert Einstein Research and Education Institute, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2022 Jul 05; Vol. 12, pp. 928578. Date of Electronic Publication: 2022 Jul 05 (Print Publication: 2022). |
| DOI: | 10.3389/fcimb.2022.928578 |
| Abstrakt: | Background: Healthcare-associated infections by carbapenem-resistant Klebsiella pneumoniae are difficult to control. Virulence and antibiotic resistance genes contribute to infection, but the mechanisms associated with the transition from colonization to infection remain unclear. Objective: We investigated the transition from carriage to infection by K. pneumoniae isolates carrying the K. pneumoniae carbapenemase-encoding gene bla Methods: KpKPC isolates detected within a 10-year period in a single tertiary-care hospital were characterized by pulsed-field gel electrophoresis (PFGE), multilocus sequencing typing, capsular lipopolysaccharide and polysaccharide typing, antimicrobial susceptibility profiles, and the presence of virulence genes. The gastrointestinal load of carbapenem-resistant Enterobacteriaceae and of bla Results: No PGFE type; ST-, K-, or O-serotypes; antimicrobial susceptibility profiles; or the presence of virulence markers, such yersiniabactin and colibactin, were associated with carriage or infection, with ST437 and ST11 being the most prevalent clones. Admission to intensive and semi-intensive care units was a risk factor for the development of infections (OR 2.79, 95% CI 1.375 to 5.687, P =0.005), but higher intestinal loads of carbapenem-resistant Enterobacteriaceae or of bla Conclusion: The presence of resistance and virulence mechanisms were not associated with progression from colonization to infection, while intestinal colonization by carbapenem-resistant Enterobacteriacea and, more specifically, the load of gastrointestinal carriage emerged as an important determinant of infection. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Migliorini, Leaden, de Sales, Correa, Marins, Koga, Toniolo, de Menezes, Martino, Mingorance and Severino.) |
| Databáze: | MEDLINE |
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