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

Abstract 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 organi...

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Published in:	Scandinavian journal of infectious diseases Vol. 45; no. 8; pp. 629 - 634
Main Authors:	Mammina, Caterina, Bonura, Celestino, Vivoli, Anna Rita, Di Bernardo, Francesca, Sodano, Concetta, Saporito, Maria Antonietta, Verde, Maria Stella, Saporito, Laura, Cracchiolo, Andrea Neville, Fabbri, Pier Giorgio, Tetamo, Romano, Palma, Daniela Maria
Format:	Journal Article
Language:	English
Published:	England Informa Healthcare 01-08-2013 Taylor & Francis
Subjects:	Acinetobacter baumannii - classification Acinetobacter baumannii - drug effects Acinetobacter baumannii - genetics Acinetobacter baumannii - isolation & purification Acinetobacter Infections - epidemiology Acinetobacter Infections - microbiology Adult Aged Aged, 80 and over Bacterial Proteins - genetics Bacterial Proteins - secretion beta-Lactamases - genetics beta-Lactamases - secretion Carbapenem resistance co-colonization Coinfection - epidemiology Coinfection - microbiology Critical Illness Drug Resistance, Bacterial Female Genotype Hospitals, General Humans intensive care unit Intensive Care Units Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Klebsiella pneumoniae - classification Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - genetics Klebsiella pneumoniae - isolation & purification Male Middle Aged Molecular Typing Risk Factors Sicily - epidemiology Sicily
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Summary:	Abstract 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-five 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 significant differences were detected between co-colonized and non co-colonized patients in infection and ICU mortality rates and length of stay after the first 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0036-5548 1651-1980
DOI:	10.3109/00365548.2013.782614