Active surveillance for carbapenemase-producing Klebsiella pneumoniae and correlation with infection in subjects attending an Italian tertiary-care hospital: a 7-year retrospective study
| Autor: | Mirko Buttrini, Carlo Chezzi, Alan Di Maio, Silvia Covan, Adriana Calderaro, Maria Cristina Arcangeletti, Alberto Ruggeri, Flora De Conto, Monica Martinelli, Isabella Rodighiero, Sara Montecchini, Mariapia Galullo, Sandra Larini |
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| Rok vydání: | 2021 |
| Předmět: |
0303 health sciences
medicine.medical_specialty High prevalence biology 030306 microbiology medicine.drug_class Klebsiella pneumoniae business.industry Antibiotics Retrospective cohort study General Medicine Urine Carbapenemase producing Tertiary care hospital biology.organism_classification 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine Medicine 030212 general & internal medicine business |
| Zdroj: | BMJ Open, Vol 11, Iss 4 (2021) |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2020-042290 |
| Popis: | ObjectivesThe distribution of carbapenemase-producing Klebsiella pneumoniae (CPKP) phenotypes and genotypes in samples collected during 2011–2018 was evaluated. The association between patients with CPKP-positive rectal swab and those with CPKP infection, as well as the overall analysis of CPKP-infected patients, was performed.SettingThe study was performed in a tertiary-care hospital located in Northern Italy.ParticipantsTwo groups were considered: 22 939 ‘at-risk’ patients submitted to active surveillance for CPKP detection in rectal swabs/stools and 1094 CPKP-infected patients in which CPKP was detected in samples other than rectal swabs.ResultsCPKP-positive rectal swabs were detected in 5% (1150/22 939). A CPKP infection was revealed in 3.1% (719/22 939) of patients: 582 with CPKP-positive rectal swab (50.6% of the 1150 CPKP-positive rectal swabs) and 137 with CPKP-negative rectal swab. The 49.4% (568/1150) of the patients with CPKP-positive rectal swab were carriers. The overall frequency of CPKP-positive patients (carriers and infected) was almost constant from 2012 to 2016 (excluding the 2015 peak) and then increased in 2017–2018. blaKPC was predominant followed by blaVIM. No difference was observed in the frequency of CPKP-positive rectal swab patients among the different material groups. Among the targeted carbapenemase genes, blaVIM was more significantly detected from urine than from other samples.ConclusionsThe high prevalence of carriers without evidence of infection, representing a potential reservoir of CPKP, suggests to maintain the guard about this problem, emphasising the importance of active surveillance for timely detection and separation of carriers, activation of contact precautions and antibiotic treatment guidance on suspicion of infection. |
| Databáze: | OpenAIRE |
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