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Title: | Factors Associated With Short-Term Eradication of Rectal Colonization by KPC-2 Producing Klebsiella pneumoniae in an Outbreak Setting |
Author: | Pellicé, Martina Rodríguez Núñez, Olga Rico, Verónica Agüero, Daiana Morata, Laura Cardozo Espinola, Celia Puerta Alcalde, Pedro Garcia Vidal, Carolina Rubio, Elisa Fernández Pittol, Mariana José Vergara Gómez, Andrea Pitart, Cristina Marco Reverté, Francesc Santana, Gemina Rodríguez Serna, Laura Vilella i Morató, Anna López, Ester Soriano Viladomiu, Alex Martínez, José Antonio (Martínez Martínez) Del Rio, Ana |
Keywords: | Klebsiella pneumoniae Farmacologia Klebsiella pneumoniae Pharmacology |
Issue Date: | 1-Feb-2021 |
Publisher: | Frontiers Media |
Abstract: | 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.3389/fmicb.2021.630826 |
It is part of: | Frontiers in Microbiology, 2021, vol. 12, num. 630826 |
URI: | http://hdl.handle.net/2445/176835 |
Related resource: | https://doi.org/10.3389/fmicb.2021.630826 |
ISSN: | 1664-302X |
Appears in Collections: | Articles publicats en revistes (Fonaments Clínics) |
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