6533b82dfe1ef96bd1290a4c

RESEARCH PRODUCT

Co-colonization with carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii in intensive care unit patients

Anna Rita VivoliLaura SaporitoMaria Antonietta SaporitoPier Giorgio FabbriDaniela Maria PalmaFrancesca Di BernardoRomano TetamoConcetta SodanoAndrea Neville CracchioloCelestino BonuraCaterina MamminaMaria Stella Verde

subject

Acinetobacter baumanniiAdultMaleMicrobiology (medical)medicine.medical_specialtyPediatricsYounger ageGenotypeCarbapenem resistant Klebsiella pneumoniaeKlebsiella pneumoniaeCritical IllnessSettore MED/42 - Igiene Generale E ApplicataHospitals Generalbeta-Lactamaseslaw.inventionBacterial ProteinsRisk FactorslawInternal medicineDrug Resistance BacterialmedicineHumansGeneral hospitalSicilyAgedAged 80 and overGeneral Immunology and MicrobiologybiologyCoinfectionbusiness.industryMajor traumaGeneral MedicineMiddle Agedbiology.organism_classificationmedicine.diseaseIntensive care unitCarbapenem resistance co-colonization intensive care unit risk factorsKlebsiella InfectionsAcinetobacter baumanniiMolecular TypingIntensive Care UnitsKlebsiella pneumoniaeInfectious DiseasesFemaleCo colonizationbusinessAcinetobacter Infections

description

Objectives: This investigation was conducted to study co-colonization by carbapenem-resistant Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) and Acinetobacter baumannii (CRAB) in intensive care unit (ICU) patients in Palermo, Sicily, a geographic area where both organisms are endemic in the healthcare setting. Risk factors at admission and during ICU stay and outcomes were also evaluated. Methods: All patients colonized by KPC-Kp, or CRAB, or both in 2 ICUs of a large general hospital during the period October 2011 – March 2012 were enrolled. Demographics and clinical data were collected. Resistance determinants and clonality of the 2 organisms were characterized by molecular methods. Results: Seventy-fi ve of 391 patients (19.2%) proved to be colonized by KPC-Kp, CRAB, or both: 30 (40%) were co-colonized and 44 (58.7%) were mono-colonized by CRAB and 1 by KPC-Kp. Younger age, major trauma, and length of stay were positively associated with co-colonization. However, no signifi cant differences were detected between co-colonized and non co-colonized patients in infection and ICU mortality rates and length of stay after the fi rst isolation. Both organisms proved to be circulating in a clonal way. Conclusions: In our setting, co-colonization by KPC-Kp and CRAB disproportionately affected young trauma patients with those with a prolonged ICU stay.

https://doi.org/10.3109/00365548.2013.782614