Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting
Background: KPC-producing Klebsiella pneumoniae (KPCKP) is a threat for patients admitted to healthcare institutions.Objectives: To assess the efficacy of several decolonization strategies for KPCKP rectal carriage.Methods: Observational study performed in a 750-bed university center from July to Oc...
Main Authors: | , , , , , , , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-02-01
|
Series: | Frontiers in Microbiology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2021.630826/full |
id |
doaj-cc387e815da045739052998ddcbda9b8 |
---|---|
record_format |
Article |
spelling |
doaj-cc387e815da045739052998ddcbda9b82021-02-01T04:28:43ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-02-011210.3389/fmicb.2021.630826630826Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak SettingMartina Pellicé0Olga Rodríguez-Núñez1Verónica Rico2Daiana Agüero3Laura Morata4Celia Cardozo5Pedro Puerta-Alcalde6Carolina Garcia-Vidal7Elisa Rubio8Mariana J. Fernandez-Pittol9Andrea Vergara10Cristina Pitart11Francesc Marco12Gemina Santana13Laura Rodríguez-Serna14Ana Vilella15Ester López16Alex Soriano17Jose Antonio Martínez18Ana Del Rio19Service of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Microbiology, Hospital Clínic de Barcelona, Barcelona, SpainService of Microbiology, Hospital Clínic de Barcelona, Barcelona, SpainService of Microbiology, Hospital Clínic de Barcelona, Barcelona, SpainService of Microbiology, Hospital Clínic de Barcelona, Barcelona, SpainService of Microbiology, Hospital Clínic de Barcelona, Barcelona, SpainService of Preventive Medicine, Hospital Clínic de Barcelona, Barcelona, SpainService of Preventive Medicine, Hospital Clínic de Barcelona, Barcelona, SpainService of Preventive Medicine, Hospital Clínic de Barcelona, Barcelona, SpainService of Pharmacy, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainService of Infectious Diseases, Hospital Clínic de Barcelona, Barcelona, SpainBackground: KPC-producing Klebsiella pneumoniae (KPCKP) is a threat for patients admitted to healthcare institutions.Objectives: To assess the efficacy of several decolonization strategies for KPCKP rectal carriage.Methods: Observational study performed in a 750-bed university center from July to October 2018 on the efficacy of a 10-day non-absorbable oral antibiotic (NAA) regimen (colistin 10 mg/ml, amikacin 8 mg/ml, and nystatin 30 mg/ml, 10 ml/6 h) vs. the same regimen followed by a probiotic (Vivomixx®) for 20 days in adult patients with KPCKP rectal colonization acquired during an outbreak.Results: Seventy-three patients colonized by KPCKP were included, of which 21 (29%) did not receive any treatment and 52 (71.2%) received NAA either alone (n = 26, 35.6%) or followed by a probiotic (n = 26, 35.6%). Eradication was observed in 56 (76.7%) patients and the only variable significantly associated with it was not receiving systemic antibiotics after diagnosis of rectal carriage [22/24 (91.6%) vs. 34/49 (69.3%), p = 0.04]. Eradication in patients receiving NAA plus probiotic was numerically but not significantly higher than that of controls [23/26 (88.4%) vs. 15/21 (71.4%), p = 0.14] and of those receiving only NAA (OR = 3.4, 95% CI = 0.78–14.7, p = 0.09).Conclusion: In an outbreak setting, rectal carriage of KPCKP persisted after a mean of 36 days in about one quarter of patients. The only factor associated with eradication was not receiving systemic antibiotic after diagnosis. A 10-day course of NAA had no impact on eradication. Probiotics after NAA may increase the decolonization rate, hence deserving further study.https://www.frontiersin.org/articles/10.3389/fmicb.2021.630826/fulldecolonizationprobioticnon-absorbable antibiotic regimenKPC-2 producing Klebsiella pneumoniaeoutbreak |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Martina Pellicé Olga Rodríguez-Núñez Verónica Rico Daiana Agüero Laura Morata Celia Cardozo Pedro Puerta-Alcalde Carolina Garcia-Vidal Elisa Rubio Mariana J. Fernandez-Pittol Andrea Vergara Cristina Pitart Francesc Marco Gemina Santana Laura Rodríguez-Serna Ana Vilella Ester López Alex Soriano Jose Antonio Martínez Ana Del Rio |
spellingShingle |
Martina Pellicé Olga Rodríguez-Núñez Verónica Rico Daiana Agüero Laura Morata Celia Cardozo Pedro Puerta-Alcalde Carolina Garcia-Vidal Elisa Rubio Mariana J. Fernandez-Pittol Andrea Vergara Cristina Pitart Francesc Marco Gemina Santana Laura Rodríguez-Serna Ana Vilella Ester López Alex Soriano Jose Antonio Martínez Ana Del Rio Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting Frontiers in Microbiology decolonization probiotic non-absorbable antibiotic regimen KPC-2 producing Klebsiella pneumoniae outbreak |
author_facet |
Martina Pellicé Olga Rodríguez-Núñez Verónica Rico Daiana Agüero Laura Morata Celia Cardozo Pedro Puerta-Alcalde Carolina Garcia-Vidal Elisa Rubio Mariana J. Fernandez-Pittol Andrea Vergara Cristina Pitart Francesc Marco Gemina Santana Laura Rodríguez-Serna Ana Vilella Ester López Alex Soriano Jose Antonio Martínez Ana Del Rio |
author_sort |
Martina Pellicé |
title |
Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
title_short |
Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
title_full |
Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
title_fullStr |
Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
title_full_unstemmed |
Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
title_sort |
factors associated with short-term eradication of rectal colonization by kpc-2 producing klebsiella pneumoniae in an outbreak setting |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Microbiology |
issn |
1664-302X |
publishDate |
2021-02-01 |
description |
Background: KPC-producing Klebsiella pneumoniae (KPCKP) is a threat for patients admitted to healthcare institutions.Objectives: To assess the efficacy of several decolonization strategies for KPCKP rectal carriage.Methods: Observational study performed in a 750-bed university center from July to October 2018 on the efficacy of a 10-day non-absorbable oral antibiotic (NAA) regimen (colistin 10 mg/ml, amikacin 8 mg/ml, and nystatin 30 mg/ml, 10 ml/6 h) vs. the same regimen followed by a probiotic (Vivomixx®) for 20 days in adult patients with KPCKP rectal colonization acquired during an outbreak.Results: Seventy-three patients colonized by KPCKP were included, of which 21 (29%) did not receive any treatment and 52 (71.2%) received NAA either alone (n = 26, 35.6%) or followed by a probiotic (n = 26, 35.6%). Eradication was observed in 56 (76.7%) patients and the only variable significantly associated with it was not receiving systemic antibiotics after diagnosis of rectal carriage [22/24 (91.6%) vs. 34/49 (69.3%), p = 0.04]. Eradication in patients receiving NAA plus probiotic was numerically but not significantly higher than that of controls [23/26 (88.4%) vs. 15/21 (71.4%), p = 0.14] and of those receiving only NAA (OR = 3.4, 95% CI = 0.78–14.7, p = 0.09).Conclusion: In an outbreak setting, rectal carriage of KPCKP persisted after a mean of 36 days in about one quarter of patients. The only factor associated with eradication was not receiving systemic antibiotic after diagnosis. A 10-day course of NAA had no impact on eradication. Probiotics after NAA may increase the decolonization rate, hence deserving further study. |
topic |
decolonization probiotic non-absorbable antibiotic regimen KPC-2 producing Klebsiella pneumoniae outbreak |
url |
https://www.frontiersin.org/articles/10.3389/fmicb.2021.630826/full |
work_keys_str_mv |
AT martinapellice factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT olgarodrigueznunez factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT veronicarico factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT daianaaguero factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT lauramorata factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT celiacardozo factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT pedropuertaalcalde factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT carolinagarciavidal factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT elisarubio factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT marianajfernandezpittol factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT andreavergara factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT cristinapitart factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT francescmarco factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT geminasantana factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT laurarodriguezserna factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT anavilella factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT esterlopez factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT alexsoriano factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT joseantoniomartinez factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting AT anadelrio factorsassociatedwithshorttermeradicationofrectalcolonizationbykpc2producingklebsiellapneumoniaeinanoutbreaksetting |
_version_ |
1724315799615700992 |